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Liquid-based Cytology for Thyroid Fine-needle Aspiration : Comparison with Conventional Smear Cytology

Liquid-based Cytology for Thyroid Fine-needle Aspiration : Comparison with Conventional Smear Cytology. Hyung Suk Seo 1 , Heesun Kim 1 , Young Hen Lee 1 , Ju-han Lee 2 Korea Univ., An-San Hosp., Dept. of Radiology 1 , Dept. of Pathology 2. Introduction. Fine Needle Aspiration (FNA)

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Liquid-based Cytology for Thyroid Fine-needle Aspiration : Comparison with Conventional Smear Cytology

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  1. Liquid-based Cytology for Thyroid Fine-needle Aspiration: Comparison with Conventional Smear Cytology Hyung Suk Seo1, Heesun Kim1, Young Hen Lee1, Ju-han Lee2 Korea Univ., An-San Hosp., Dept. of Radiology1, Dept. of Pathology2

  2. Introduction • Fine Needle Aspiration (FNA) • Best and initial evaluation and diagnosis of thyroid lesion • Conventional Smear (CS) Cytology • Traditional standard of FNA biopsy • Limitation of inadequate sampling • low cellularity • bloody background

  3. Introduction • Liquid-based (LB) Cytology • SurePathTM (SP) • (TriPath Imaging Inc., Burlington, North Carolina, USA) • approved by FDA • CytoRich® Red Fixative • reduce red blood cells & background debris • improved nuclear and cytoplasmic stain • Replacing CS cytology in Pap smear or nongynecologic cytology

  4. Introduction • Comparison between LB and CS Cytology in Thyroid FNA in Previous Study • LB cytology • higher cellularity, lower nondiagnostic rate • clean background slide, easy to interprete • more accentuated nuclear irregularity in papillary carcinoma • Similar diagnostic accuracy in 2 methods • benign & malignant tumors, thyroiditis

  5. Purpose • Comparison of Diagnostic Adequacy between LB and CS Cytology in Thyroid FNA • according to nodular composition • according to skill & experience of operator

  6. Materials • Demographics • Total 279 patients • mean age: 49.5±12.8 years, M:F=40:239 • cytologic proven case :malignancy (30), atypical cell (33), benign (143) • Details of retrospective study

  7. Methods • Classification of nodular composition • by the percentage of cystic portion • 3 categories • solid (<50%), cystic (>50%) , spongy-form • data number according to nodular composition

  8. Methods • Diagnostic adequacy of cytology • by amount of follicular cells & cellular preservation • 2 categories • inadequate • adequate :including pathologically proven cases as suboptimal and optimal

  9. Results • Diagnostic adequacy according to nodular composition (ANOVA test) • LB cytology superior to CS cytology in solid and cystic thyroid nodule • especially, LB cytology much superior in cystic nodule • no difference in spongy-form nodule

  10. Results • Diagnostic adequacy according to operator’s skill (ANOVA test) • LB cytology superior to CS cytology in both faculty and resident regardless of operator’s skill

  11. Conclusion • In the ultrasound-guided thyroid FNA, LB cytology can increase the diagnostic adequacy in solid and cystic thyroid nodules . • Especially , LB cytology can achieve superior diagnostic adequacy in more than 50% cystic thyroid nodule. • LB cytology can increase the diagnostic adequacy by both faculty and resident regardless of operator’s skill. • LB cytology may be the method for the optimal diagnostic adequacy instead of CS in thyroid FNA.

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