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Danese et al., Roma, Italy, compared the characteristics of conventional
fine needle aspiration (FNA) in 4986 patients and ultrasound guided FNA
in 4697 patients. Overall sensitivity and accuracy was 93% vs. 100% and
91.3% vs. 96.4% respectively. Sonography-guided FNA had a positive predictive
value of 100% and a negative predictive value of 99.9%. (Comment: These
results are excellent and point to a highly developed experience of the
different specialists involved, in particular the cytologist. Not all clinics
have those beautiful results.)
Carpi et al., Pisa, Italy, compared the results of FNA with those of large needle biopsy histology (NB). In total 1668 patients were evaluated with FNA and 31% also with NB. Sensitivity for FNA vs. NB was 93% vs. 64%, specificity 57% vs. 82%. Further results shows that NB increases overall sensitivity if applied to nodules with benign or suspect cytology. (Comment: It is questionable if NB should routinely be applied when FNA result is benign since sensitivity of FNA is 93%.) |
