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Office-Based Ultrasound-Guided FNA Superior Palpation Technique in Diagnosing Head and Neck Lesions ALEXANDRIA, Va -- March 3, 2010 -- Office-based, surgeon-performed, ultrasound-guided, fine needle aspiration (FNA) of head and neck lesions yields a statistically significant higher diagnostic rate compared with the standard palpation technique, according to a study published in the March issue of Otolaryngology-Head and Neck Surgery. The efficacy of ultrasound-guided FNA has been well documented in many areas of the body, leading to its acceptance as the standard of care among radiologists and many cytopathologists. However, while the utility of ultrasound in the head and neck is widely appreciated and employed by the radiology community, clinicians in the United States have not embraced office-based ultrasound. The study authors sought to provide additional evidence and support for this procedure in order to ensure appropriate use by the clinical community. In the randomised, controlled trial of 81 adults, researchers divided participants into 2 groups, using either ultrasound-guided or traditional palpation-guided FNA to evaluate an identified head and neck mass. The researchers then measured variables and outcomes for tissue adequacy rates, tissue type, and operator variability. Following 3 passes using either palpation or ultrasound-guidance, a comparative tissue adequacy rate of 84% for ultrasound-guidance (vs 58% for standard palpation) was established. With regard to tissue type, a statistically significant comparative diagnostic advantage for ultrasound guidance was observed in thyroid tissue, while remaining insignificant for lymphatic and salivary tissues. “With respect to FNA of palpable head and neck masses, ultrasound guidance in the hands of the clinician yields a statistically significant improved specimen adequacy rate after 3 passes, when compared with traditional palpation technique,” the authors wrote. “This represents a discernable clinical benefit for the patient in terms of reducing the number of passes required, as well as the need and cost for a repeat office FNA or a referral for ultrasound guidance.” SOURCE: American Academy of Otolaryngology -- Head and Neck Surgery E-mail this page to a friend or colleague! To print, use this version