Fine needle aspiration biopsy. Has its time come?

Area of Science:

• Medical diagnostics
• Surgical pathology

Background:

• Fine needle aspiration biopsy (FNAB) is experiencing a resurgence in clinical practice within the United States.
• A recent survey indicated significant uncertainty among clinicians regarding the appropriate utilization of FNAB.
• This diagnostic technique offers a minimally invasive approach for tissue sampling.

Purpose of the Study:

• To delineate the scope and application of fine needle aspiration biopsy as implemented at the University of California, San Francisco (UCSF) and San Francisco General Hospital (SFGH).
• To provide a comprehensive review of the existing literature on the accuracy of fine needle aspiration biopsy.
• To address the clinical uncertainty surrounding the use of FNAB by presenting practical insights and data.

Main Methods:

• Descriptive review of fine needle aspiration biopsy procedures and protocols at UCSF and SFGH.
• Systematic literature search and analysis of published accuracy data for fine needle aspiration biopsy.
• Synthesis of clinical practice experience with relevant scientific literature.

Main Results:

• The practice scope of fine needle aspiration biopsy at UCSF and SFGH is detailed, outlining its role in various diagnostic scenarios.
• Review of global literature demonstrates established accuracy benchmarks for fine needle aspiration biopsy across different anatomical sites and suspected pathologies.
• The findings highlight the efficacy and reliability of FNAB when performed and interpreted correctly.

Conclusions:

• Fine needle aspiration biopsy is a valuable and accurate diagnostic tool with a defined scope of practice.
• Addressing clinician uncertainty through clear guidelines and evidence-based reviews can promote wider and more effective adoption of fine needle aspiration biopsy.
• The study underscores the importance of standardized practices and accessible accuracy data to support the revival of fine needle aspiration biopsy in the US.