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Ultrasound-Guided Fine Needle Aspiration Biopsy of Thyroid

Last updated Nov. 14, 2016

DoveMed.com

During the Ultrasound-Guided Fine Needle Aspiration Biopsy of the Thyroid radiology procedure, a small sample of thyroid gland tissue is removed and examined under a microscope, in order to determine whether it is benign or malignant. This is a microscopic pathology image of a thyroid nodule showing a papillary carcinoma of thyroid on a fine needle aspirataion (FNA) biopsy smear.


Background Information:

What are the other Names for the Procedure?

  • Fine Needle Aspiration Biopsy of Thyroid via Ultrasound
  • USG Fine Needle Aspiration Thyroid Biopsy
  • USG FNA Biopsy - Thyroid

What is Ultrasound-Guided Fine Needle Aspiration Biopsy of the Thyroid radiology procedure? (General Explanation)

  • The thyroid gland is a butterfly-shaped gland, located right about the neckline, in front of the neck or “Adam’s apple”
  • During the Ultrasound-Guided Fine Needle Aspiration Biopsy of Thyroid procedure, a small sample of thyroid gland tissue is removed and examined under a microscope, in order to determine whether it is benign or malignant

What part of the Body does the Procedure involve?

The Ultrasound-Guided FNA Thyroid Biopsy involves the neck region of the body.

Why is the Ultrasound-Guided Fine Needle Aspiration Biopsy of the Thyroid radiology procedure Performed?

A Ultrasound-Guided Fine Needle Aspiration Biopsy of Thyroid procedure is performed for the following reasons:

  • To determine the cause of a nodule in the thyroid gland, and if the nodule is benign or malignant
  • To treat thyroid cysts

What is the Equipment used? (Description of Equipment)

The equipment for ultrasound imaging consists of:

  • An ultrasound transducer
  • A computer monitor
  • A central processing unit
  • A printer
  • For the FNA, a fine needle attached to a syringe, smaller than needles usually used to draw blood

A transducer is used to send high frequency sound waves in the body and the computer creates the image based on the echoes of that sound returning from the patient’s body.

What are the Recent Advances in the Procedure?

There have been no recent advances to replace the Ultrasound-Guided FNA Thyroid Biopsy procedure. 

What is the Cost of performing the Ultrasound-Guided Fine Needle Aspiration Biopsy of the Thyroid radiology procedure?

The cost of the Ultrasound-Guided Fine Needle Aspiration Biopsy of Thyroid procedure depends on a variety of factors, such as the type of your health insurance, annual deductibles, co-pay requirements, out-of-network and in-network of your healthcare providers and healthcare facilities. 

In many cases, an estimate may be provided before the procedure. The final amount depends upon the findings during the surgery/procedure and post-operative care that is necessary. 

When do you need a Second Opinion, prior to the Procedure?

  • It is normal for a patient to feel uncomfortable and confused with a sudden inflow of information regarding the USG FNA Biopsy - Thyroid procedure and what needs to be done.
  • If the patient needs further reassurance or a second opinion, a physician will almost always assist in recommending another physician.
  • Also, if the procedure involves multiple steps or has many alternatives, the patient may take a second opinion to understand and choose the best one. They can also choose to approach another physician independently. 

What are some Helpful Resources?

http://www.radiologyinfo.org/en/info.cfm?pg=thyroidbiopsy (accessed on 08/03/2014)

Prior to Ultrasound-Guided Fine Needle Aspiration Biopsy of the Thyroid radiology procedure:

How does the Ultrasound-Guided Fine Needle Aspiration Biopsy of the Thyroid radiology procedure work?

An Ultrasound-Guided Fine Needle Aspiration Biopsy of Thyroid procedure works in the following manner:

  • The ultrasound procedure works on similar principles used in sonar by submarines, to determine the size and shape of the object and how far away the object is
  • The transducer sends out high frequency sound waves in the body. When sound waves echo back from the body, the microphone in the transducer records the changes in the sound
  • And using the changes in the sound, it is possible to determine the shape, size, or any other changes in the structure of the organ
  • Using the change in the echoed sound, a computer produces a picture in real-time on the screen
  • Doppler ultrasound is used to determine the direction and speed of the blood cells
  • Using ultrasound, the location of suspicious mass is determined, and a biopsy needle inserted and guided into the mass 

How is the Ultrasound-Guided Fine Needle Aspiration Biopsy of the Thyroid radiology procedure Performed?

The Ultrasound-Guided Fine Needle Aspiration Biopsy of Thyroid procedure is performed in the following manner:

  • The patient lies on the table face-up
  • An intravenous (IV) line is inserted into the patient’s arm
  • Local or general anesthesia is injected to numb the neck region
  • The ultrasound transducer is placed on the neck and the suspicious mass located
  • A biopsy needle is inserted and guided to the suspicious mass, by monitoring advancement of the needle on a computer
  • A tissue sample is removed and the opening of the skin is covered
  • Pressure is applied on the site of needle insertion, to avoid bleeding
  • A marker may be put to locate the site in future

Where is the Procedure Performed?

A USG Fine Needle Aspiration Biopsy of Thyroid procedure is performed as an outpatient procedure, at a hospital.

Who Performs the Procedure?

A USG Fine Needle Aspiration Biopsy of Thyroid procedure is usually done by a radiologist or a qualified healthcare professional with the assistance of a radiology technologist.

How long will the Procedure take?

Normally, the Ultrasound-Guided Fine Needle Aspiration Biopsy of Thyroid procedure takes about 20 minutes.

Who interprets the Result?

  • The tissue removed from the USG Fine Needle Aspiration Biopsy of Thyroid procedure is sent to the pathologist
  • The pathologist will examine the tissue under a microscope and give the results to the interventional radiologist

What Preparations are needed, prior to the Procedure?

The following preparations may be needed prior to the USG Fine Needle Aspiration Biopsy of Thyroid procedure:

  • The physician may evaluate the individual’s medical history to gain a comprehensive knowledge of the overall health status of the patient, including information related to the medications that are being currently taken
  • Do inform the medical professional if you have a history of any medical conditions, such as a heart disease, asthma, diabetes, or kidney disease
  • Do inform the medical professional about any allergies, especially related to barium or iodinated contrast material, which may be used in the procedure
  • It is advisable to wear comfortable and loose clothes. Avoid wearing any metal objects or jewelry, as it may interfere with the procedure
  • It is highly recommended to inform your healthcare professional, if you are pregnant or breastfeeding
  • The patient may be asked to avoid eating or drinking, several hours before the test
  • The patients should notify their physicians, if they are using any blood thinners, such as aspirin, Coumadin, Plavix, or Lovenox
  • In case of children, sedation may be used

What is the Consent Process before the Procedure?

A physician will request your consent for an Ultrasound-Guided Fine Needle Aspiration Biopsy of Thyroid procedure using an Informed Consent Form.

Consent for the Procedure: A “consent” is your approval to undergo a procedure. A consent form is signed after the risks and benefits of the procedure, and alternative treatment options, are discussed. This process is called informed consent.

You must sign the forms only after you are totally satisfied with the answers to your questions. In case of minors and individuals unable to personally give their consent, the individual’s legal guardian or next of kin, shall give their consent for the procedure.

What are the Benefits versus Risks, for this Procedure?

Following are the benefits of the USG Fine Needle Aspiration Biopsy of Thyroid procedure:

  • The recovery time is relatively brief
  • The procedure is not as expensive as a surgical biopsy or a stereotactic biopsy
  • It is less invasive than a surgical biopsy
  • The procedure can be performed in a short amount of time
  • The ultrasound does not involve the use of any ionizing radiation
  • In ultrasound biopsy, the needle movement can be followed in real-time, as it moves to the abnormal tissue mass

Following are the risks of the USG Fine Needle Aspiration Biopsy of Thyroid procedure:

  • Any procedure, where the skin is penetrated carries a risk of infection. Although, the probability of an infection requiring antibiotic treatment, is less than 1 per 1,000 procedures

What are the Limitations of Ultrasound-Guided Fine Needle Aspiration Biopsy of the Thyroid radiology procedure?

Following are the limitations of the USG Fine Needle Aspiration Biopsy of Thyroid procedure:

  • This procedure may not present the severity/seriousness of the disease; or it may miss the lesion. In such cases, surgical biopsies may be necessary
  • Any calcification in the cancerous nodules may not be clearly visible through this examination
  • The presence of small, suspicious masses may make for difficult detection, with ultrasound guided biopsy

What are some Questions for your Physician?

Some of the basic questions that you might ask your health care provider or physician are as follows:

  • What is the Ultrasound-Guided Fine Needle Aspiration Biopsy of Thyroid procedure?
  • Why is this procedure necessary? How will it help?
  • How soon should I get it done? Is it an emergency?
  • Who are the medical personnel involved in this procedure?
  • Where is the biopsy procedure performed?
  • What are the risks while performing the procedure?
  • What are the complications that might take place, during recovery?
  • What are the possible side effects from the procedure? How can I minimize these side effects?
  • How long will it take to recover? When can I resume normal work?
  • How many such procedures have you (the physician) performed?
  • Are there any lifestyle restrictions or modifications required, after the procedure is performed?
  • Are there any follow-up tests, periodic visits to the healthcare facility required, after the procedure?
  • What are the costs involved?

During the Ultrasound-Guided Fine Needle Aspiration Biopsy of the Thyroid radiology procedure:

What is to be expected during the Ultrasound-Guided Fine Needle Aspiration Biopsy of the Thyroid radiology procedure?

The following may be expected during the USG FNA Biopsy – Thyroid procedure:

  • The patient may feel some pain, due to the needle insertion into the skin
  • During biopsy requiring surgery, the patient is given anesthesia
  • The patient may feel a little discomfort as he/she has to lie face down, for an extended period of time

What kind of Anesthesia is given, during the Procedure?

A general anesthesia will be injected to numb the path of the needle, during the USG FNA Biopsy – Thyroid procedure.

How much Blood will you lose, during the Procedure?

There is only a minimal blood loss, during the USG Fine Needle Aspiration Biopsy of Thyroid procedure.

What are the possible Risks and Complications during the Ultrasound-Guided Fine Needle Aspiration Biopsy of the Thyroid radiology procedure?

During the procedure, there is a slight risk of infection, since the skin is penetrated by a needle. However, this risk is very low; it is less than 1 in 1000 procedures.

What Post-Operative Care is needed at the Healthcare Facility after the Ultrasound-Guided Fine Needle Aspiration Biopsy of the Thyroid radiology procedure?

There is no postoperative care necessary after the Ultrasound-Guided Fine Needle Aspiration Biopsy of Thyroid procedure, at the healthcare facility. 

After the Ultrasound-Guided Fine Needle Aspiration Biopsy of the Thyroid radiology procedure:

What is to be expected after the Ultrasound-Guided Fine Needle Aspiration Biopsy of the Thyroid radiology procedure?

The following may be expected after the USG FNA Biopsy - Thyroid procedure:

  • The doctor may recommend taking over-the-counter pain medication, if there is swelling after the procedure
  • A marker may be left at the biopsy site, in order to locate it for future purposes; however, this does not cause any additional pain or discomfort to the individual

When do you need to call your Physician?

If there are any signs, such as swelling, bleeding, or redness in the breast following an Ultrasound-Guided Thyroid Biopsy procedure, the physician should be informed about it.

What Post-Operative Care is needed at Home after the Ultrasound-Guided Fine Needle Aspiration Biopsy of the Thyroid radiology procedure?

There is no postoperative care required after the Ultrasound-Guided FNA Biopsy of Thyroid procedure.

How long does it normally take to fully recover, from the Procedure?

The patient may return to their normal activities 24 hours after the USG FNA Biopsy of Thyroid procedure.

Additional Information:

What happens to tissue (if any), taken out during the Procedure?

The tissue is taken for further examination and later disposed as per the standard medical procedure. 

When should you expect results from the pathologist regarding tissue taken out, during the Procedure?

  • The tissue removed is processed in the laboratory under a pathologist's supervision
  • Slide(s) are prepared once the tissue is processed and is examined by a pathologist and a pathology report issued
  • Depending on the complexity of the case, issue of the report may take anywhere between 72 hours to a week's time 

Who will you receive a Bill from, after the Ultrasound-Guided Fine Needle Aspiration Biopsy of the Thyroid radiology procedure?

It is important to note that the number of bills that the patient may receive depends on the arrangement the healthcare facility has with the physician and other healthcare providers.

Sometimes, the patient may get a single bill that includes the healthcare facility and the consultant physician charges. Sometimes, the patient might get multiple bills depending on the healthcare provider involved. For instance, the patient may get a bill from:

  • The hospital, where the procedure is performed
  • The radiologist, performing the procedure; physicians of other specialities, such as a general surgeon, pathologist, or endocrinologist, may also perform the procedure
  • Healthcare providers, physicians, who are involved in the process

The patient is advised to inquire and confirm the type of billing, before the Ultrasound-Guided Fine Needle Aspiration Biopsy of Thyroid procedure is performed.

Reviewed and Approved by a member of the DoveMed Editorial Board
First uploaded: Aug. 18, 2014
Last updated: Nov. 14, 2016

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