The Effectiveness of the Device for Vacuum Fine-Needle Aspiration Biopsy in Focal Thyroid Pathology

Purpose: Determination of the effectiveness of using vacuum fine-needle aspiration biopsy under ultrasound control in patients with focal thyroid pathology.

Material and methods: The modified original experimental sample for vacuum fine-needle aspiration biopsy (patent RU No. 2757525) was developed with the help of which 48 vacuum fine-needle aspiration biopsy were performed under the control of ultrasound navigation in patients with focal thyroid pathology. The device is a full-fledged vacuum compressor that creates a negative pressure in the range from –0.1 to –0.8 bar, which is connected to a syringe using a metal container, foot switches, electromagnetic valves, high-strength hoses and an adapter, where a high discharge power is created and fragmentation and aspiration of cellular material occurs. The degree of discharge depended on the assumed morphological structure of thyroid nodes, which were determined using multiparametric ultrasound. The average vacuum level was selected in the range from –0.3 to –0.5 bar, which is significantly higher than the level of discharge created by a 10 ml syringe (–0.2 bar).

Results: During the vacuum fine-needle aspiration biopsy, no complications were detected during and after the manipulation. In the group of patients, 72.1 % (n = 32) women prevailed, the average age was 59.0±5.5 years. The collection of cytological material was carried out much easier, since when using v-TAB, the discharge in the syringe is formed using an apparatus that is kept at a constant level, which eliminated the need for translational movements of the syringe piston and needle in the focus for greater collection of cytological material, this indicates a low level of uninformative cytological conclusion (Bethesda I), n = 5 (11.2 %).

Conclusions: 1. The implementation of vacuum fine-needle aspiration biopsy allows to improve the quality of sampling of cellular material, which affects the informativeness of cytological examination of nodular formations of the thyroid gland.

2. The vacuum fine-needle aspiration biopsy allows you to individualize the procedure depending on the ultrasound semiotics of the nodular formation of the thyroid gland.

3. The vacuum fine-needle aspiration biopsy minimizes the number of uncontrolled needle movements during a biopsy, which reduces the risk of complications.

1. Novikova AA. Environmental aspects of thyroid cancer in the Smolensk region, problems of diagnosis and treatment (1986-2016). Smolensk Medical Almanac. 2018;(4):51-5. (In Russian).

2. Kaprin AD, Starinsky VV, Petrova GV. The state of oncological care to the population of Russia in 2018. 2019 (In Russian).

3. Timofeeva LA. Differential diagnosis of nodular neoplasms of the thyroid gland: multiparametric ultrasound examination in the paradigm of stratification risks: dis. Dr. Sci. Med. K, 2019. 342 p. (In Russian).

4. Beltsevich DG, Mudunov, AM, Vanushko VE, et al. Differentiated thyroid cancer. Modern Oncology. 2020;22(4). (In Russian).

5. Beltsevich DG, Vanushko VE, Melnichenko GA, Rumyantsev PO, Fadeev VV. Clinical recommendations of the Russian Association of Endocrinologists for the diagnosis and treatment of (many)nodular goiter in adults. Endocrine Surgery. 2016;10(1):5-12. DOI: 10.14341/serg2015115-21 (In Russian).

6. Borsukov AV, Sholokhov VN. Practical guide. Minimally invasive technologies under ultrasound navigation in modern clinical practice. Smolensk; 2009:28-33. (In Russian).

7. Borsukov AV. Analysis of the American and European versions of THIRADS-2017: reproducibility possibilities in the ultrasound diagnostics room. Bulletin of New Medical Technologies. 2019;26(2):25-8. (In Russian).

8. Dedov II, Melnichenko GA, Abdulkhabirova FM, et al. Russian Clinical Guidelines. Endocrinology. Moscow. 2016. (In Russian).

9. Beltsevich DG, Vanushko VE. Modern aspects of diagnosis of nodular goiter. Endocrine Surgery. 2014;8(3):5-13. DOI: 10.14341/serg201435-13 (In Russian).

10. Machała E, Sopiński J, Iavorska I, et al. Correlation of fine needle aspiration cytology of thyroid gland with histopathological results. Polish J Surg. 2018;90:13-9.

11. Borsukov AV, Amosov VI, Busko EA, et al. Ultrasound elastography: how to do it right. Smolensk. 2018:75-77. (In Russian).

12. Russ G, Bonnema SJ, Erdogan S. et al. European Thyroid Association guidelines for ultrasound malignancy risk stratification of thyroid nodules in adults: the EU-TIRADS. Eur Thyroid J. 2017;6(5):225-37.

13. Patent No. 2757525 C1 Russian Federation, IPC A61B 10/02. Device for performing vacuum fine needle aspiration biopsy under ultrasound visual control: No. 2020137115: application 10.11.2020: publ. 18.10.2021. Tagil AO, Borsukov AV. (In Russian).

14. Fisenko EP, Borsukov AV, Zabolotskaya NV, et al. Proposals for the implementation of the TRADOS stratification system in Russia. Ultrasound and Functional Diagnostics. 2019;(4):36. (In Russian).

15. Cibas ES, Ali SZ, The 2017 Bethesda System for Reporting Thyroid Cytopathology. J Am Soc Cytopathol. 2017;6:217-22. DOI: 10.1016/j.jasc.2017.09.002.

16. Vorobyev SL. Morphological diagnosis of thyroid diseases. St. Petersburg. 2014. 104 p. (In Russian).

17. Brito JP, Yarur A J, Prokop LJ, et al. Prevalence of thyroid cancer in multinodular goiter versus single nodule: a systematic review and meta-analysis. Thyroid. 2013;23(4):449-55.

18. Gandolfi PP, Frisina A, Raffa M, et al. The incidence of thyroid carcinoma in multinodular goiter: retrospective analysis. Acta Biomed. 2004;75(2):114-7.