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Henry PMN, Boag AM, Dandrieux JRS, Rossi R, Woods GA. Diagnostic yield of percutaneous, ultrasound-guided, fine needle aspirates of the gastrointestinal wall: a retrospective analysis of 152 samples. J Small Anim Pract 2024. [PMID: 38958024 DOI: 10.1111/jsap.13759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 03/24/2024] [Accepted: 05/27/2024] [Indexed: 07/04/2024]
Abstract
OBJECTIVES The aim was to assess the technical success of percutaneous ultrasound-guided fine needle aspirates of gastrointestinal wall lesions and evaluate predictors of success. Secondary aims included comparing the cytological diagnosis with histopathology, evaluating the utility of concurrent locoregional lymph node cytology and assessing the procedure's complication rate. MATERIAL AND METHODS Gastrointestinal wall cytology from 75 dogs and 70 cats obtained between 2018 and 2023 were reviewed and categorised as successful (resulting in a diagnostic cytology report) and accurate (resulting in the correct diagnosis when compared to histopathology). Unsuccessful fine needle aspirates, not submitted for cytology, were not recorded. Variables recorded included animal signalment, lesion and lymph node's appearance on ultrasound, size, location, number of smears submitted and experience of the ultrasonographer. RESULTS One hundred and fifty-two reports were analysed. Eighty-eight (58%) were successful: three normal epithelium, 21 inflammatory processes and 64 neoplasms. Variables associated with increased technical success included description of a mass, higher number of slides submitted and thickness of gastrointestinal lesion on ultrasound. Comparison with histopathology, performed for 17 lesions, showed discrepancies in eight, complete agreement in seven and partial in two. Eighty-four loco-regional lymph nodes were sampled, of which, 67 were successful (80%) and 52 brought additional clinical information (supporting GI wall cytology or diagnosing neoplasia not identified on GI wall cytology). No complication strictly attributable to gastrointestinal wall sampling was reported but when possibly related, death of the patient occurred in 2.5% of cases. CLINICAL SIGNIFICANCE Ultrasound-guided fine needle aspirate of gastrointestinal wall had moderate accuracy and was unsuccessful in 42% of cases, but technical success increased when sampling mass lesions, thicker intestinal layers and submitting more slides.
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Affiliation(s)
- P M N Henry
- Hospital for Small Animals, The Royal (Dick) School of Veterinary Studies, University of Edinburgh, Easter Bush Campus, Midlothian, UK
| | - A M Boag
- Hospital for Small Animals, The Royal (Dick) School of Veterinary Studies, University of Edinburgh, Easter Bush Campus, Midlothian, UK
| | - J R S Dandrieux
- Hospital for Small Animals, The Royal (Dick) School of Veterinary Studies, University of Edinburgh, Easter Bush Campus, Midlothian, UK
| | - R Rossi
- Hospital for Small Animals, The Royal (Dick) School of Veterinary Studies, University of Edinburgh, Easter Bush Campus, Midlothian, UK
| | - G A Woods
- Hospital for Small Animals, The Royal (Dick) School of Veterinary Studies, University of Edinburgh, Easter Bush Campus, Midlothian, UK
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Marcos R, Fonte-Oliveira L, Santos M, Caniatti M. An immersive simulation strategy to teach cytology sample collection methods and basic diagnosis skills: A two academic center study. Vet Clin Pathol 2023; 52:722-731. [PMID: 37460418 DOI: 10.1111/vcp.13280] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 04/29/2023] [Accepted: 05/25/2023] [Indexed: 12/29/2023]
Abstract
BACKGROUND Collecting cytology samples and making simple diagnoses are skills taught in veterinary universities, mostly in a passive way. Simulators enhance practical skills learning, increasing student engagement through immersive activities. These strategies have not been carefully assessed in veterinary cytology. OBJECTIVES This study aimed to describe a simulator developed for training cytology sample collection methods and assess the utility of an immersive simulation strategy to learn and practice the collection of cytology samples. METHODS A flipped classroom with a station design was followed. Students first watched video tutorials on sampling collection, listened to brief cases' clinical histories, and moved to immersive simulator stations. There, they practiced imprints, swabs, and fine-needle aspiration (FNA). Microscopic observation of the material was available through augmented reality tools. Students were evaluated by Objective Structured Clinical Examination (OSCE) tools on their ability to perform FNA on stuffed animal models. Students answered two questionnaires addressing their learning outcomes. RESULTS Second- and third-year students from two centers (n = 129) practiced cytologic collection methods in simulators which significantly changed their willingness to perform FNA in live animals after the class activities. OSCE pass rates over 90% were obtained for most steps of FNA, and students rated the activity as essential/very relevant for learning. CONCLUSIONS Immersive simulation strategies were effective at increasing student comfort with cytologic sampling techniques. This approach should be included in the veterinary curriculum as it can increase the quality of cytology samples and could potentially improve the cytologic diagnosis of a submitted sample.
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Affiliation(s)
- Ricardo Marcos
- Cytology and Hematology Diagnostic Services, Laboratory of Histology and Embryology, School of Medicine and Biomedical Sciences (ICBAS), University of Porto, Porto, Portugal
| | - Luísa Fonte-Oliveira
- Cytology and Hematology Diagnostic Services, Laboratory of Histology and Embryology, School of Medicine and Biomedical Sciences (ICBAS), University of Porto, Porto, Portugal
| | - Marta Santos
- Cytology and Hematology Diagnostic Services, Laboratory of Histology and Embryology, School of Medicine and Biomedical Sciences (ICBAS), University of Porto, Porto, Portugal
| | - Mario Caniatti
- Dipartimento di Medicina Veterinaria e Scienze Animali (DIVAS), Università degli Studi di Milano, Milan, Italy
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Llanos C, Holmes E, White C, Jasensky AK, Fitzgerald E. Diagnostic quality of ultrasound-guided fine-needle aspirates samples from the canine liver and spleen is not significantly affected by using 22-, 23-, and 25-gauge needles. Vet Radiol Ultrasound 2023; 64:966-972. [PMID: 37549956 DOI: 10.1111/vru.13290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Revised: 07/22/2023] [Accepted: 07/26/2023] [Indexed: 08/09/2023] Open
Abstract
Ultrasound-guided fine-needle aspirates (FNA) of the liver and spleen for cytological analysis are a commonly performed procedure in canine veterinary practice. Based on our review of the literature, this is the first published study investigating whether needle size affects the diagnostic quality of hepatic and splenic samples. The aim of this prospective analytical study was to compare the diagnostic quality of ultrasound-guided FNA cytological samples of canine liver and spleen based on cellularity, blood contamination, and overall cell preservation between three different needle sizes (22-, 23-, and 25-gauge). A total of 282 splenic aspirates from 94 dogs and 348 hepatic aspirates from 116 dogs were enrolled in the study and examined by two board-certified veterinary clinical pathologists. In this study, no significant differences in diagnostic quality were identified between different needle gauge sizes when sampling canine liver and spleen. Blood contamination was higher using 22-gauge needles compared with 25-gauge needles (P = 0.024) when sampling the liver.
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Affiliation(s)
- Cesar Llanos
- Department of Clinical Science and Services, Royal Veterinary College, University of London, Hertfordshire, UK
| | - Emma Holmes
- Department of Pathobiology and Population Sciences, Royal Veterinary College, University of London, Hertfordshire, UK
| | | | - Anne-Katherine Jasensky
- Department of Pathobiology and Population Sciences, Royal Veterinary College, University of London, Hertfordshire, UK
| | - Ella Fitzgerald
- Department of Clinical Science and Services, Royal Veterinary College, University of London, Hertfordshire, UK
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Karakitsou V, Christopher MM, Meletis E, Kostoulas P, Pardali D, Koutinas CK, Mylonakis ME. A comparison of cytologic quality in fine-needle specimens obtained with and without aspiration from superficial lymph nodes in the dog. J Small Anim Pract 2021; 63:16-21. [PMID: 34590715 DOI: 10.1111/jsap.13429] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 07/14/2021] [Accepted: 08/26/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To assess the impact of aspiration on cytologic quality of fine-needle specimens obtained from lymph nodes of dogs and to compare the level of agreement of the cytologic diagnosis between the two sampling techniques. MATERIALS AND METHODS Fifty-three client-owned dogs were prospectively enrolled. Client-owned dogs were prospectively enrolled in the study if cytologic examination of lymph nodes was indicated in the course of their clinical diagnostic work-up. In each dog, two superficial, palpably accessible lymph nodes were sampled: one by fine-needle aspiration and the other by fine-needle non-aspiration, using a 21-Gauge needle with or without a 5-mL syringe. Cytologic quality was assessed in duplicate smears assessed by two observers who rated cellularity, blood contamination, thickness, cell preservation and cytoplasmic fragmentation using a predefined scoring system. RESULTS Fifty-three client-owned dogs were included in the study. No significant difference was found in rating scores between the two sampling techniques for any of the cytologic quality parameters assessed. Cohen's kappa coefficient was 0.84 (95% confidence interval 0.68-1.00), indicating diagnostic agreement between the sampling techniques. CLINICAL SIGNIFICANCE In this study, both fine-needle aspiration and fine-needle non-aspiration techniques yielded lymph node specimens of comparable cytologic quality and with acceptable agreement in cytologic diagnosis.
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Affiliation(s)
- V Karakitsou
- Companion Animal Clinic, School of Veterinary Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki (CAC-AUTh), 54627 Thessaloniki, Greece
| | - M M Christopher
- Department of Pathology, Microbiology and Immunology, School of Veterinary Medicine, University of California-Davis, 95616 Davis, CA, USA
| | - E Meletis
- Laboratory of Epidemiology, School of Public and One (Integrated) Health, School of Health Sciences, University of Thessaly, 43100 Karditsa, Greece
| | - P Kostoulas
- Laboratory of Epidemiology, School of Public and One (Integrated) Health, School of Health Sciences, University of Thessaly, 43100 Karditsa, Greece
| | - D Pardali
- Diagnostic Laboratory, School of Veterinary Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54627, Thessaloniki, Greece
| | - C K Koutinas
- Companion Animal Clinic, School of Veterinary Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki (CAC-AUTh), 54627 Thessaloniki, Greece
| | - M E Mylonakis
- Companion Animal Clinic, School of Veterinary Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki (CAC-AUTh), 54627 Thessaloniki, Greece
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Thiemeyer H, Taher L, Schille JT, Harder L, Hungerbuehler SO, Mischke R, Hewicker-Trautwein M, Kiełbowicz Z, Brenig B, Schütz E, Beck J, Murua Escobar H, Nolte I. Suitability of ultrasound-guided fine-needle aspiration biopsy for transcriptome sequencing of the canine prostate. Sci Rep 2019; 9:13216. [PMID: 31519932 PMCID: PMC6744464 DOI: 10.1038/s41598-019-49271-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Accepted: 08/15/2019] [Indexed: 02/06/2023] Open
Abstract
Ultrasound-guided fine-needle aspiration (US-FNA) biopsy is a widely used minimally invasive sampling procedure for cytological diagnosis. This study investigates the feasibility of using US-FNA samples for both cytological diagnosis and whole transcriptome RNA-sequencing analysis (RNA-Seq), with the ultimate aim of improving canine prostate cancer management. The feasibility of the US-FNA procedure was evaluated intra vitam on 43 dogs. Additionally, aspirates from 31 euthanised dogs were collected for standardising the procedure. Each aspirate was separated into two subsamples: for cytology and RNA extraction. Additional prostate tissue samples served as control for RNA quantity and quality evaluation, and differential expression analysis. The US-FNA sampling procedure was feasible in 95% of dogs. RNA isolation of US-FNA samples was successfully performed using phenol-chloroform extraction. The extracted RNA of 56% of a subset of US-FNA samples met the quality requirements for RNA-Seq. Expression analysis revealed that only 153 genes were exclusively differentially expressed between non-malignant US-FNAs and tissues. Moreover, only 36 differentially expressed genes were associated with the US-FNA sampling technique and unrelated to the diagnosis. Furthermore, the gene expression profiles clearly distinguished between non-malignant and malignant samples. This proves US-FNA to be useful for molecular profiling.
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Affiliation(s)
- H Thiemeyer
- Small Animal Clinic, University of Veterinary Medicine Hannover, Foundation, Hannover, Germany
- Department of Haematology/Oncology/Palliative Care, Rostock University Medical Centre, Rostock, Germany
| | - L Taher
- Division of Bioinformatics, Department of Biology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - J T Schille
- Small Animal Clinic, University of Veterinary Medicine Hannover, Foundation, Hannover, Germany
- Department of Haematology/Oncology/Palliative Care, Rostock University Medical Centre, Rostock, Germany
| | - L Harder
- Small Animal Clinic, University of Veterinary Medicine Hannover, Foundation, Hannover, Germany
| | - S O Hungerbuehler
- Small Animal Clinic, University of Veterinary Medicine Hannover, Foundation, Hannover, Germany
| | - R Mischke
- Small Animal Clinic, University of Veterinary Medicine Hannover, Foundation, Hannover, Germany
| | - M Hewicker-Trautwein
- Institute of Pathology, University of Veterinary Medicine Hannover, Foundation, Hannover, Germany
| | - Z Kiełbowicz
- Department and Clinic of Veterinary Surgery, Faculty of Veterinary Medicine, Wroclaw University of Environmental and Life Sciences, Wrocław, Poland
| | - B Brenig
- University of Göttingen, Institute of Veterinary Medicine, Göttingen, Germany
| | - E Schütz
- Chronix Biomedical, Göttingen, Germany
| | - J Beck
- Chronix Biomedical, Göttingen, Germany
| | - H Murua Escobar
- Small Animal Clinic, University of Veterinary Medicine Hannover, Foundation, Hannover, Germany
- Department of Haematology/Oncology/Palliative Care, Rostock University Medical Centre, Rostock, Germany
| | - I Nolte
- Small Animal Clinic, University of Veterinary Medicine Hannover, Foundation, Hannover, Germany.
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Arai S, Rist P, Clancey N, Gilroy C, Stryhn H, Amsellem P. Fine-needle aspiration of cutaneous, subcutaneous, and intracavitary masses in dogs and cats using 22- vs 25-gauge needles. Vet Clin Pathol 2019; 48:287-292. [PMID: 31210389 DOI: 10.1111/vcp.12751] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Revised: 08/27/2018] [Accepted: 09/25/2018] [Indexed: 01/18/2023]
Abstract
BACKGROUND Fine-needle aspiration (FNA) is a common procedure as a diagnostic tool in veterinary medicine. However, it is unclear whether the gauge of the needle affects the quality of cytology. OBJECTIVE This study compared the quality of cytologic samples obtained via FNA using 22- or 25-gauge needles. METHODS Fine-needle aspiration was performed on 50 masses (cutaneous, subcutaneous, or intracavitary) obtained from client-owned animals. The size of the needle was randomly assigned using either of the following two sequences: 22-25-22 gauge or 25-22-25 gauge. Samples were evaluated by two board-certified clinical pathologists to assess cellularity, blood contamination, amount of cellular debris, degree of cellular trauma, and the overall ability to make a diagnosis for each sample. RESULTS No significant difference was detected between the 22- and 25-gauge needle samples for cellularity, whereas a significant difference was present for blood contamination, amount of cellular debris, and degree of cellular trauma. The overall ability to make a diagnosis was not significantly affected by the needle gauge. The degree of cellular trauma was significantly increased in intracavitary samples. CONCLUSIONS AND CLINICAL RELEVANCE Needle gauge is a contributing factor to FNA sample quality. However, it did not affect the overall ability to make a diagnosis. Samples obtained using 25-gauge needles resulted in less blood contamination yet increased cellular trauma compared to 22-gauge needle samples.
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Affiliation(s)
- Shiori Arai
- Department of Companion Animals, Atlantic Veterinary College, University of Prince Edward Island, Charlottetown, PE, Canada
| | - Paul Rist
- Department of Companion Animals, Atlantic Veterinary College, University of Prince Edward Island, Charlottetown, PE, Canada
| | - Noel Clancey
- Department of Pathology and Microbiology, Atlantic Veterinary College, University of Prince Edward Island, Charlottetown, PE, Canada
| | - Cornelia Gilroy
- Department of Pathology and Microbiology, Atlantic Veterinary College, University of Prince Edward Island, Charlottetown, PE, Canada
| | - Henrik Stryhn
- Department of Health Management, Atlantic Veterinary College, University of Prince Edward Island, Charlottetown, PE, Canada
| | - Pierre Amsellem
- Department of Companion Animals, Atlantic Veterinary College, University of Prince Edward Island, Charlottetown, PE, Canada
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