Improving the sample sufficiency of ultrasound guided fine needle aspirations of thyroid nodules
By Melanie McColgan, Altnagelvin Hospital, Western Health and Social Care Trust
Aim
Improving the sample sufficiency of ultrasound-guided fine needle aspirations of thyroid nodules through the introduction of a sonographer-led neck ultrasound service and multidisciplinary working with cytopathology
colleagues.
Methods
Sonographers completed formal education in neck ultrasound and FNAC. Mentorship by consultant radiologists to meet competencies in scanning, reporting and sampling of neck lumps. Sonographers
underwent training with biomedical scientist to learn how to correctly prepare slides for FNA samples. Following discussions with cytopathologist, trial of new fixative solution, (CytoLyt®) for needle washings.
Results from all FNAs undertaken were audited (successful sample recorded when adequate and diagnostic sample achieved).
Results
The sonographer-led neck service and the use of CytoLyt® with correctly prepared slides was introduced in July 2021 and this led to a marked and sustained decrease in sample insufficiency for thyroid FNAs during the
18 month period post changes.
Conclusion
Introduction of the CytoLyt® solution and improved slide preparation has significantly decreased the insufficiency rate of thyroid FNAs. Continual audit of sample adequacy ensures confidence in service offered
by sonographers is maintained.