Combined Fine Needle Cytology and Core Needle Biopsy of the Liver in One Setting: An Experience of 29 Cases
Valeria Ciliberti, Anna La Mura, Elisabetta Maffei, Angela D'Ardia, Mario Masarone, Pio Zeppa, Alessandro Caputo, Antonio D'AntonioABSTRACT
Introduction
Core needle biopsy (CNB) and fine needle aspiration cytology (FNAC) are routinely used in the diagnosis of hepatic nodules. Despite their advantages, both procedures have certain limitations. Recently, the combined use of FNAC and CNB in the same setting has been explored. We report a series of 29 combined hepatic FNAC–CNB procedures performed by an interventional cytopathologist. This series was compared with 50 cases of hepatic FNAC and 27 cases of hepatic CNB performed separately by clinicians and radiologists.
Materials and Methods
Twenty‐nine combined FNAC–CNB procedures performed over a 5‐year period were analyzed. FNAC diagnoses were compared and integrated with subsequent CNB diagnoses, and the impact of CNB on the diagnostic process was evaluated. In addition, 50 cases of hepatic FNAC and 27 cases of hepatic CNB performed outside our outpatient setting were analyzed to assess diagnostic performance in different workflows.
Results
When combined with FNAC, CNB had a positive impact on the diagnostic process in 82.8% of cases ( n = 24/29), resulting in a complete diagnostic process in 89.7% of cases ( n = 26/29). Without the combination of ROSE and CNB, FNAC alone achieved a complete diagnostic process in 60.0% of cases ( n = 30/50), while CNB performed without FNAC and ROSE yielded a complete diagnostic process in 55.7% of cases ( n = 15/27).
Conclusions
The combined use of FNAC and CNB in a single setting improves diagnostic performance, optimizes specimen management, and identifies patients truly in need of CNB.