US GUIDED FNAC

US Guided FNAC Overview

Ultrasound (US) Guided Fine Needle Aspiration Cytology (FNAC) is a diagnostic procedure that employs ultrasound technology to guide a fine needle to aspirate cell samples. FNAC is a less invasive test that attempts to diagnose cysts or possible tumours in the thyroid, breast, lymph nodes, and other superficial organs. All patients who are scheduled for this test are advised to discontinue their blood-thinning medication a few days prior to the test. 

What is US Guided FNAC? 

US Guided FNAC incorporates imaging ultrasound with a fine needle to collect cell samples. The ultrasound uses high-frequency sound waves to produce internal images of certain body structures, which helps the Radiologist know which specific structure or zone to target. Once the target zone is located, a fine needle is placed in the target area under ultrasound guidance, and cell samples are aspirated for abnormal growth or cancer detection. 

Types of US Guided FNAC  

Two major categories of US Guided FNAC exist: 

• Thyroid FNAC: FNAC of a thyroid nodule/mass  
• Non-thyroid FNAC: FNAC of a lesion in superficial organs like breast, lymph nodes, salivary glands. 

List of Parameters Considered During US Guided FNAC

The following parameters are taken into consideration by the radiologists during the exam: 

• Lesion's size, form, and position in relation to other structures. 
• Lesion's echotexture and echogenicity (brightness) 
• Lesion's margins and bordering tissues. 
• Marked features or characteristic features such as calcifications. 
• Age of the patient and prior medical and radiological data. 

Reasons For Undertaking A US Guided FNAC

Some common indications for US Guided FNAC are: 

• Assess for highly suspicious thyroid nodules or masses 
• Screen abnormal breast lumps and lesions. 
• Evaluate clinically enlarged lymph nodes 
• Investigate lumps or masses in other superficial organs of unknown origin. 
• Cancer staging diagnostic procedures. 

When and Who Needs to Take a US Guided FNAC? 

These patients or symptoms may warrant a US Guided FNAC recommendation from a clinician as follow: 

• Thyroid nodules or masses that are of concern. 
• Lumps or lesions in the breast that are abnormal. 
• Lymph nodes that are bigger than normal. 
• Lumps or masses that are abnormal in other organs located superficially. 
• Other test results like CT or MRI scans which shows imaging abnormalities. 

Certain patient groups who are more likely to need US Guided FNAC, include: 

• Patients with a known malignancy or with a history of having received radiation. 
• Patients with a family history of thyroid or breast cancer. 
• Patients with abnormal findings in a physical exam like lumps or masses that can be felt. 

Benefits of Taking the Test

The advantages of US Guided FNAC are: 

• Kind of operation which is less invasive than traditional surgical methods. 
• Achieve diagnosis and initiate treatment guidelines promptly. 
• Possibility of complications is small. 
• Better diagnosis accuracy than clinical assessment only. 

Illnesses Diagnosed with US Guided FNAC

Some diseases diagnosed with US Guided FNAC include: 

• Thyroid cancer (papillary, follicular, or medullary) 
• Breast Cancer 
• Lymphoma 
• Salivary gland tumours 
• Disease that has spread to lymph nodes or other superficial organs. 

Preparing for US Guided FNAC

Ensure to avoid blood-thinning medications a couple of days prior to the procedure. Patients should also notify their doctor about any allergies or other medical problems. Additionally, it is advised to wear loose clothing that is comfortable. 

Pre-requisites 

The patient is required to refrain from eating at least 4 hours prior for procedures involving aspiration of the thyroid nodule. These patients should also consider avoiding blood thinning medications, such as aspirin or warfarin. 

Best Time to Take the US Guided FNAC 

The procedure can be scheduled at any time, but it is typically recommended to schedule it when the lesion is most palpable or when the patient requires easy follow up visits. 

Eligibility 

Ultrasound Guided FNAC is typically advised for: 

• Patients with suspicious lesions or masses. 
• Patients who had a history of cancer or radiation. 
• Patients with abnormal physical examination findings or imaging studies. 

Procedure for Taking a US Guided FNAC 

This test takes around 15 to 30 minutes, and is performed in 7 steps: 

1. Patient preparation and positioning 
2. Ultrasound assessment of the lesion. 
3. Local anaesthetic injection. 
4. Ultrasound guided fine needle placement. 
5. Cell sampling. 
6. Fine needle withdrawal, apply pressure to site. 
7. Sample(s) analysis. 

Caution Before Taking the Test 

Patients need to address the following topics with their doctor: 

• Any known medication or material allergies from the procedure. 
• Any existing bleeding problem or meds that may cause bleeding. 
• Whether they are pregnant, or nursing.