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Friday 14 June 2019

Measured Negative Pressure in Syringes Used for Aspiration Biopsy: Volume and Pressure Relationship


                                     https://www.austinpublishinggroup.com/thyroid-research/



Thyroidcancer is the most common endocrine malignancy in the United States. Approximately 53,990 new cases are expected to be diagnosed in 2018. Thyroid nodules are a common clinical finding especially after the increased use of high resolution imaging such us Ultrasound (US) technology, computed tomography and magnetic resonance imaging but thyroid nodules have a low risk of malignancy of between 5 to 10%. Clinical evaluation to diagnose malignancy includes a careful clinical evaluation, TSH evaluation, a thyroid US exam and a Fine-Needle Aspiration Biopsy (FNAB) of nodules. Thyroid FNAB is the most accurate test for determining malignancy and is the recommended diagnostic test in the initial evaluation of thyroid nodules by the American Thyroid Association and the American Association of Clinical Endocrinologists .

Thebiopsy technique often uses aspiration to obtain cells or fluid from the thyroid nodule using a needle attached to a syringe. The conceptual basis of a fine needle aspiration biopsy is pulling back on the syringe plunger creates a suction (negative pressure) to aspirate cells from a thyroid nodule into the needle for cytological examination. A nonscientific survey of the 10 endocrinologists at Boston Medical Center who perform thyroid fine needle biopsies showed 1 physician use 0-1 milliliter (mL), 4 physicians use 2-3mL, 3 physicians use 4-6mL and 2 physicians use > 6mL of aspiration during a FNAB. When asked why they used this volume, there was no scientific basis or knowledge of expert guidelines to support their clinical habit.

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