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Cytopathology. 2012 Oct;23(5):330-3. doi: 10.1111/j.1365-2303.2011.00871.x. Epub 2011 May 25.

Effect of ultrasound transmission gel on ultrasound-guided fine needle aspiration cytological specimens of thyroid.

Author information

1
Department of Diagnostic Imaging, St Francis Xavier Cabrini Hospital, Malvern, Victoria, Australia. assemalalzad@gmail.com

Abstract

OBJECTIVE:

To investigate prospectively the diagnostic impact of ultrasound coupling gel on thyroid specimens obtained under ultrasound guidance.

METHODS:

Patients presenting for ultrasound-guided fine needle aspiration (USG-FNA) of the thyroid were invited to participate in the study. Four specimens per nodule were collected: two using chlorhexdine wash and two using sterile, colourless ultrasound gel as couplant according to routine protocol. All slides were analysed in a blinded fashion by two senior cytologists for the presence or absence of ultrasound gel-induced artefacts. The presence of gel-induced artefacts between the two groups was analyzed using Pearson's chi-square test. Kappa statistics were used to measure the inter-rater agreement between the cytologists.

RESULTS:

Twenty thyroid nodules comprising 80 specimen slides were collected. On slides collected with gel, cytological artefacts were detected in 60-65% of cases compared with 10-15% of cases without gel (P<0.001). The inter-rater agreement between the two observers was very good (κ=0.84). Two of the 14 patients required repeat FNA due to non-diagnostic cytology results caused by inadequate sampling and gel-induced artefacts.

CONCLUSIONS:

Clinical cytopathologists, radiologists and sonographers should be aware of the potential for ultrasound gel to cause significant artefacts on cytological specimens. Our findings suggest that staff involved in USG-FNA cytology should remove the gel carefully before taking the aspirate.

[Indexed for MEDLINE]

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