ARRS: On-site pathologist can reduce unnecessary biopsies

If a facility utilizes an on-site pathologist during ultrasound-guided thyroid biopsy procedures, the number of repeat biopsies can be decreased, according to the results of a recent study presented at the American Roentgen Ray Society (ARRS) 2010 Annual Meeting in San Diego on May 5.

Led by Wui K. Chong, MD, of the University of North Carolina in Chapel Hill, and colleagues, the study indicated a high number of inadequate biopsies, in which the pathologist deems there is an insufficient amount of information to make a diagnosis.

“Requests for ultrasound-guided biopsies for the diagnosis of thyroid nodules have increased rapidly in recent years, putting a strain on radiology departments everywhere,” said Chong. “Repeat biopsy is unpleasant and inconvenient for the patient and is obviously wasteful.”

The researchers compared 200 biopsies carried out at the university that were performed with a pathologist on-site and 200 that did not have a pathologist on-site. Keeping all other factors consistent, 13.5 percent of the biopsies performed without a pathologist on-site were found to be inadequate, compared to only 5 percent that were performed with a pathologist on-site.

Based on their findings, Chong and colleagues recommend the use of on-site pathology by radiologists performing a large number of thyroid biopsy cases, noting that it could reduce the need for repeat biopsies by nearly 60 percent.

“Having a pathologist on-site to review the specimen can cut down on the number of patients returning for repeat biopsy, thus making more efficient use of resources,” concluded Chong.

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