Thyroid Biopsy 101: Endocrinologists are better at adequacy than radiologists.

Thyroid Biopsy 101: Endocrinologists are better at adequacy than radiologists.

Thyroid Biopsy 101: Endocrinologists are better at adequacy than radiologists.

Thyroid Biopsy 101: Endocrinologists are better at adequacy than radiologists.

5% of biopsies done by radiologists are inadequate and patients need rebiopsy.The first biopsy should have been done by an endocrinologist to save patients for a traumatic return for a second biopsy.

Dr.Gutter’s comments:

  1. Endocrinology had a higher rate of cytologic adequacy than radiology.

  2. Radiology had a higher rate of molecular adequacy than endocrinology.
  3. One institution had all thyroid biopsies done by either endocrinologists or radiologists only.
  4. The study comprised 5,810 specimens from Endocrinology and 4,597 from Radiology.
  5. More Endocrinology specimens were satisfactory for cytology diagnosis than those from Radiology (94.7% vs. 90.0%, p<0.001)
  6. For molecular adequacy, fewer Endocrinology specimens were optimal than specimens from Radiology for both the 7-gene panel era (76.2% vs. 82.9%, p<0.001) and the ThyroSeq era (88.1% vs. 91.9%, p=0.049).
  7. Because adequacy in cytology is the key starting point when most never need molecular marker studies as they are benign or diagnostic or high risk for cancer.
  8. The 20 % Class III needing markers can still get as good as radiologists with their Thyro/Seq system. 88% to 91.9%
  9. Go with an endocrinologists to do your biopsy.
  10. Radiologists tend to use bigger needles and get blood which cause bloody distortion of the cells.
  11. They also tend to use thin prep which is less valuable than smears for fine tuning the diagnosis.
  12. Endocrinologists make smears rather than thin prep in most cases.
  13. tyd-aspiration-biops_fig3 The usual procedure is to jam one or two times and put the bloody fluid in a thin prep tube.
  14. thin-prep-pap-test-kit
  15. See me at 310-393-8860 or thyroid.manager@protonmail.com.
  16. Dr.G.
Comparison of the Collection Approaches of Two Large Thyroid Fine Needle Aspiration Practices Reveals Differing Advantages for Cytology and Molecular Testing Adequacy Rates
•https://doi.org/10.1016/j.jasc.2019.03.004

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