Literature DB >> 16627921

Cost-effectiveness of fine-needle-aspiration cytology of thyroid nodules with intranodular vascular pattern using two different needle types.

C Cappelli1, A Tironi, C Mattanza, D Cumetti, B Agosti, E Gandossi, I Pirola, E De Martino, L Cherubini, L Micheletti, M Castellano, E Agabiti Rosei.   

Abstract

OBJECTIVE: To compare the cytological findings of hypoechoic thyroid nodules with intranodular vascular pattern (pattern II) obtained by two different needles (Neolus 25 gauge, Chemil, Wenzhou, China vs Yale Spinal 25 gauge, Becton Dickinson, Madrid, Spain) in euthyroid patients and to evaluate their cost-effectiveness.
METHODS: From January 2001 to December 2003, 480 euthyroid patients with a hypoechoic thyroid nodule pattern II were referred for US-FNAC. The nodules were alternatively evaluated by Neolus or by Yale Spinal with the stylet (YS+) or without the stylet (YS-), in order to evaluate if the cytological results could be due to the presence of the stylet or to the different length of the two needles. For each nodule two passes were performed and the material was obtained by capillary action. Material was smeared on slides, fixed, and stained by Papanicolaou techniques. Cytological specimens were evaluated in blind by the same experienced cytopathologist.
RESULTS: Inadequate cytological specimens because of blood contamination were present in 30 (18.7%) samples by Neolus needle and in 22 (13.8%) by YS- compared to only 5 (3.1%) by YS+. In 6 (20%) cases of the 30 repeated US-FNAC by Neolus and in 4 (18%) of the 22 US-FNAC by YS-, material remained inadequate for diagnosis because of blood contamination. All the five repeated samples obtained by YS+ became adequate for diagnosis and resulted benign nodules. Direct costs of US-FNAC procedure are currently 72.30 Euro including cytological examination. The cost of Neolus and Yale needles is 0.19 Euro and 3.0 Euro, respectively. The estimated total cost to obtain a cytological diagnosis by a Neolus needle (160 + 30 repeated US-FNAC) was 13809.2 Euro vs 12919.5 Euro by Yale Spinal needle (160 + 5 repeated US-FNAC).
CONCLUSION: This study demonstrates that the use of Yale Spinal needles greatly reduces inadequate cytological specimens, and therefore limits both direct and indirect costs.

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Year:  2005        PMID: 16627921     DOI: 10.1385/ep:16:4:349

Source DB:  PubMed          Journal:  Endocr Pathol        ISSN: 1046-3976            Impact factor:   3.943


  23 in total

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2.  Guidelines of the Papanicolaou Society of Cytopathology for the examination of fine-needle aspiration specimens from thyroid nodules. The Papanicolaou Society of Cytopathology Task Force on Standards of Practice.

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Authors:  M Regina Castro; Hossein Gharib
Journal:  Endocr Pract       Date:  2003 Mar-Apr       Impact factor: 3.443

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  3 in total

1.  Spinal needle improves diagnostic cytological specimens of thyroid nodules.

Authors:  C Cappelli; A Tironi; I Pirola; E Gandossi; A Delbarba; B Agosti; M Castellano; E Agabiti Rosei
Journal:  J Endocrinol Invest       Date:  2008-01       Impact factor: 4.256

2.  Should we use stylet needles for aspiration cytology of thyroid nodules?

Authors:  Carlo Cappelli
Journal:  Nat Clin Pract Endocrinol Metab       Date:  2008-12-02

3.  Comparison of two different standards of care in detecting malignant thyroid nodules using thyroid fine-needle aspiration.

Authors:  Xiaoyun Liu; Lijun Zhu; Zhixiao Wang; Dai Cui; Huanhuan Chen; Ling Wei; Yunsong Wu; Rong Rong; Yan Wu; Qing Yao; Zhihong Zhang; Edmund S Cibas; Erik K Alexander; Tao Yang
Journal:  Mol Clin Oncol       Date:  2015-01-22
  3 in total

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