A comparison of the results of monolayer versus smear cytopreparatory techniques for fine-needle aspiration in 100 consecutive patients undergoing thyroidectomy: A surgeon’s perspective

OBJECTIVE: To compare thyroid fine-needle aspiration (FNA) using monolayer (MT) versus conventional smear (CS) cytopreparatory techniques with final histology. STUDY DESIGN: Retrospective review of 100 consecutive thyroidectomies. Setting Tertiary care university affiliated medical center. RESULTS: 26% of MT aspirates were inadequate compared with 3% of CS aspirates (P < 0.05). The negative predictive values for MT and CS were 86% and 100%, respectively. The positive predictive values for MT and CS were 69% and 90%, respectively. CONCLUSIONS: Fewer inadequate specimens will be obtained with CS than with MT. A clinician performing FNA can obtain adequate specimens at a rate comparable to that of a hospital-based cytopathologist. SIGNIFICANCE: CS provides greater assurance to the patient and the surgeon that a thyroid nodule with a FNA interpreted as benign can be observed. A higher percentage of patients with malignant tumor will receive thyroidectomy with the use of CS technique for FNA. EBM RATING: B-3.