Neck lump clinics: is on-site assessment of fine needle aspirate diagnostic adequacy cost-effective?

Abstract

AbstractObjectives:To establish the diagnostic adequacy of ultrasound-guided fine needle aspiration cytology samples at the East Berkshire neck lump clinic, and to perform a cost-benefit analysis related to the hypothetical addition of an on-site cytology technician (required to review fine needle aspiration specimen adequacy).Method:The adequacy of all ultrasound-guided fine needle aspiration procedures was reviewed from 1 January to 30 June 2011. These results were used in the cost-benefit analysis related to on-site cytology assessment.Results:Of the 307 ultrasound-guided fine needle aspiration cytology procedures performed over 6 months, 67 (22 per cent) were reported to be non-diagnostic. Operator experience was found to correlate significantly with diagnostic adequacy (p < 0.001). Only 5 per cent of all fine needle aspirations were initially non-diagnostic but diagnostic on repeat sampling. This suggests that the financial and time costs of on-site fine needle aspirate adequacy assessment would outweigh any benefit.Conclusion:In this series, the experience of individuals performing fine needle aspirations was the most important factor related to adequacy.