Value Of Rapid On-Site Evaluation For Ultrasound-guided Thyroid Fine Needle Aspiration

OBJECTIVEApplication of rapid on-site evaluation(ROSE)for ultrasound-guided thyroid fine needle aspiration biopsy thyroid fine needle aspiration(FNA)is controversial.Therefore,ROSE has not been universally applied.This study aimed to evaluate the value of ROSE for ultrasound-guided thyroid FNA,in order to reduce the trauma and complications of patients and further improve the diagnostic rate of FNA.METHODSA total of 997 patients with 1103 suspicious thyroid nodules had ultrasound-guided FNA performed from January 2016 to February 2018.There were 513 nodules with ROSE and590 nodules without ROSE.The basic parameters,needle passes,procedural times,incidence of complications,cytopathological results and the accordance rate of the cytopathology with the histopathology results of thyroid FNA with or without ROSE were compared.The improvement of the diagnostic level of subsets of suspicious thyroid nodules and different TI-RADS classification thyroid nodules with and without ROSE for thyroid aspirates were further discussed.Data analysis was performed with SPSS 22.0 version.Analysis was performed using Pearson’s?~2 or Fisher’s exact test for categorical data and the two sample t-test for two independent samples to determine statistical significance.P values≤0.05 were considered statistically significant.RESULT(1)There was a significantly smaller number of needle passes and less procedural times of all thyroid nodules FNA with ROSE than without ROSE(Z=24.18,P<0.05;Z=11.11,P<0.05)and there was no significant difference in the complication rate of FNA with and without ROSE(p>0.05).(2)There was no significant effect of ROSE on the cytopathological results of all thyroid nodules FNA(p>0.05).(3)The success rates of aspirate increased in sub-centimeter nodules,mixed solid-cystic nodules,macro-calcified nodules and hyper-vascular nodules with ROSE(?2=7.56,P=0.006;?2=4.18,P=0.041;?2=11.13,P=0.001;?2=4.42,P=0.036).(4)The success rates of aspirate increased in 4a and 4b nodules with ROSE(?2=6.45,P=0.011;?2=3.95,P=0.047),and there was a statistical difference between 4a and 4b categories nodules(?2=3.98,P=0.046).(5)No statistical significance was found in the accordance rate of cytopathology and histopathological results of all nodules and TI-RADS 4a,4b,4c,5 categories nodules,whether or not there was a rapid onsite assessment(p>0.05).CONCLUSIONROSE for thyroid FNA reduces the number of needle passes and procedural times.The success rate of puncture were improved not only in part of thyroid nodules,which tended to be difficult to diagnose with FNA,but also in TI-RADS 4a,4b categories nodules,especially for 4a nodules which tended to benign.Therefore,ROSE has a higher clinical application value and is worth popularizing.