Fine-needle biopsy: prospective comparison of aspiration versus nonaspiration techniques in the abdomen

A prospective study was designed to compare the aspiration (suction method) and nonaspiration (nonsuction method) techniques of fine-needle biopsy (FNB) in 50 consecutive patients with abdominal pathologic conditions. Sites of biopsy included liver (n = 24), retroperitoneum (n = 9), adrenal gland (n = 5), pancreas (n = 4), omentum (n = 4), and miscellaneous sites (n = 4). Aspiration and nonaspiration FNBs were performed in each lesion with 22-gauge needles, and results were interpreted by a single cytopathologist. Cytologic specimens obtained with each technique were analyzed for diagnostic accuracy, total number of cell clusters per biopsy (graded 0-10, 10-20, 20-30, and > 30), presence of crush artifact, and amount of blood present (graded from 0 to +3). No significant differences were seen between the aspiration and nonaspiration techniques with regard to number of cell clusters per biopsy (44 of 50 specimens vs 42 of 50) (P < .0003), amount of blood present (grade 2.3 vs 2.2) (P < .0003), and amount of crush artifact. The positive predictive value for the aspiration technique was 91.5% versus 74% for the nonaspiration technique. The aspiration technique of FNB appears superior to the nonaspiration technique in the abdomen.