ORIGINAL ARTICLE

One nodule–one punction–one slide: Optimizing thyroid fine-needle aspiration for a digital workflow

Ariana Maia

Endocrinology Department, Centro Hospitalar Universitário de Santo António, Porto, Portugal

Bárbara Carvalho

Pathology Laboratory, Institute of Molecular Pathology and Immunology of University of Porto (IPATIMUP), Porto, Portugal

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João Vale,

João Vale

Pathology Laboratory, Institute of Molecular Pathology and Immunology of University of Porto (IPATIMUP), Porto, Portugal

Department of Pathological, Cytological and Tanathological Anatomy, School of Health of Polytechnic Institute of Porto (ESS | P.PORTO), Porto, Portugal

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Mónica Curado,

Mónica Curado

Pathology Laboratory, Institute of Molecular Pathology and Immunology of University of Porto (IPATIMUP), Porto, Portugal

Department of Pathological, Cytological and Tanathological Anatomy, School of Health of Polytechnic Institute of Porto (ESS | P.PORTO), Porto, Portugal

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Carmel Ryan,

Carmel Ryan

Pathology Department, St Marks Hospital, Harrow, United Kingdom

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António Polónia,

António Polónia

Pathology Laboratory, Institute of Molecular Pathology and Immunology of University of Porto (IPATIMUP), Porto, Portugal

Glycobiology in cancer, i3S—Instituto de Investigação e Inovação em Saúde, Porto, Portugal

Departamento de sistemas biofuncionais do corpo humano da Escola de Medicina e Ciências Biomédicas, Instituto de Investigação, Inovação e Desenvolvimento, Fundação Fernando Pessoa (FP-I3ID), Porto, Portugal

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Catarina Eloy,

Corresponding Author

Catarina Eloy

[email protected]

orcid.org/0000-0001-7642-1280

Pathology Laboratory, Institute of Molecular Pathology and Immunology of University of Porto (IPATIMUP), Porto, Portugal

Pathology Department, Medical Faculty of University of Porto, Porto, Portugal

Correspondence

Catarina Eloy, Pathology Laboratory, Institute of Molecular Pathology and Immunology of University of Porto (IPATIMUP), Rua Júlio Amaral de Carvalho 45, 4200-135 Porto, Portugal.

Email: [email protected]

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Ariana Maia,

Ariana Maia

Endocrinology Department, Centro Hospitalar Universitário de Santo António, Porto, Portugal

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Bárbara Carvalho,

Bárbara Carvalho

Pathology Laboratory, Institute of Molecular Pathology and Immunology of University of Porto (IPATIMUP), Porto, Portugal

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João Vale,

João Vale

Pathology Laboratory, Institute of Molecular Pathology and Immunology of University of Porto (IPATIMUP), Porto, Portugal

Department of Pathological, Cytological and Tanathological Anatomy, School of Health of Polytechnic Institute of Porto (ESS | P.PORTO), Porto, Portugal

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Mónica Curado,

Mónica Curado

Pathology Laboratory, Institute of Molecular Pathology and Immunology of University of Porto (IPATIMUP), Porto, Portugal

Department of Pathological, Cytological and Tanathological Anatomy, School of Health of Polytechnic Institute of Porto (ESS | P.PORTO), Porto, Portugal

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Carmel Ryan,

Carmel Ryan

Pathology Department, St Marks Hospital, Harrow, United Kingdom

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António Polónia,

António Polónia

Pathology Laboratory, Institute of Molecular Pathology and Immunology of University of Porto (IPATIMUP), Porto, Portugal

Glycobiology in cancer, i3S—Instituto de Investigação e Inovação em Saúde, Porto, Portugal

Search for more papers by this author

Catarina Eloy,

Corresponding Author

Catarina Eloy

[email protected]

orcid.org/0000-0001-7642-1280

Pathology Laboratory, Institute of Molecular Pathology and Immunology of University of Porto (IPATIMUP), Porto, Portugal

Pathology Department, Medical Faculty of University of Porto, Porto, Portugal

Correspondence

Catarina Eloy, Pathology Laboratory, Institute of Molecular Pathology and Immunology of University of Porto (IPATIMUP), Rua Júlio Amaral de Carvalho 45, 4200-135 Porto, Portugal.

Email: [email protected]

Search for more papers by this author

First published: 20 November 2023

https://doi.org/10.1111/cyt.13338

Citations: 1

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Abstract

Objective

Interventional pathologists have expanded their expertise by acquiring proficiency in ultrasound-guided thyroid fine-needle aspiration biopsy (FNAB) and are now required to optimize punction procedures due to low resources and digital workflows. The aim of this study is to compare FNAB sample adequacy in two series with one versus two slides available for cytopathological analysis and its influence on diagnosis categorization, time taken to reach a final diagnosis, scanning time and size of the digital files produced.

Methods

Patients were retrospectively selected based on the sampling of thyroid nodules using either two glass slides (two-slide group) or one slide only (one-slide group) and cytological diagnosis was performed using the second edition of the Bethesda system. For each group, the initial 15 cases were sorted to be scanned.

Results

From a total of 713 procedures, 328 were sampled into two slides and 385 on one slide only. No significant differences were found regarding nodule size, location or EU-TIRADS classification between the two groups. The one-slide group did not exhibit a higher prevalence of non-diagnostic or atypia of undetermined significance (AUS) categories. As expected, the mean time taken to finalize diagnoses in cases where only one slide was prepared was 1.2 days faster. Scanning time and total file size were also significantly smaller in the one-slide group.

Conclusions

Adopting the ‘one nodule–one puncture–one slide’ strategy for thyroid FNAB optimization enhances procedural efficiency in digital workflows, leading to cost savings without compromising diagnostic accuracy.

Graphical Abstract

This study demonstrates that adopting the ‘one nodule–one puncture–one slide’ strategy for thyroid fine-needle aspiration biopsy enhances procedural efficiency in digital workflows, leading to cost savings without compromising diagnostic accuracy.

CONFLICT OF INTEREST STATEMENT

C.E. consulted for Mindpeak, MSD and Leica. A.P. consults for Indica Labs. Other authors declare no conflict of interest.

Open Research

DATA AVAILABILITY STATEMENT

Data generated or analysed during this study are partially included in this published article and may be provided after reasonable request.

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Citing Literature

Volume36, Issue4

Special Issue: Interventional Cytopathology

July 2025

Pages 333-338