IMPROVEMENT OF INSTRUMENTAL DIAGNOSTICS OF NODAL PATHOLOGY OF THE THYROID GLAND

Abstract

Aim. Increasing the efficiency of fine-needle aspiration biopsy (FNA) of thyroid nodules at the pre-analytical stage by optimizing biopsy technology under ultrasound control. Materials and methods. The material for the study was the results of TAP of thyroid nodules of 1960 patients (aged 16 to 82 years). All patients in the period 2015-2022 underwent FNA of nodular formations of the thyroid gland on the basis of the Department of X-ray and Functional Diagnostics with Ultrasound Studies of the Medical Center of the SIS "RPC PCM" SAD.  FNA was performed by ultrasound doctors of the highest qualification category using a biopsy gun and exclusively under ultrasound control. Sonographic criteria proposed by the ATA (American Thyroid Association) were used to determine the indications for FNA. For 402 patients, biopsy was performed under ultrasound control and without assessment of aspirate adequacy during manipulation. For 1,552 patients during the biopsy an express cytological method was used to assess the adequacy of aspirates, which was performed by an ultrasound doctor who had mastered the technique of preliminary cytological analysis. The efficiency of both methods was compared according to the criterion of informativeness of the obtained cytomorphological material. Results. In total, among 1,960 cases of FNA of thyroid nodules, cytological results were not informative in 55 cases (2.81%). In the FNA group without express cytological analysis (402 cases), uninformative cytological results were found in 49 cases (12.19%), and with the use of express cytological analysis during biopsy (1558 cases), uninformative cytological findings were found in only 6 patients (0.39%). Conclusions. The application of the optimized technology of FNA of thyroid nodules under ultrasound control with express cytology of aspirate by an ultrasound doctor increases the informativeness of the method and the economic component of FNA.