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Program Number: B314
Session Name: Poster Session

Preoperative Diagnosis Using a Vibrating Device for Fine Needle Aspiration Cytology in Salivary Gland Tumors

Tsuyoshi Kojima, MD, PhD¹; Ryusuke Hori, MD, PhD²; Shiori Oda, MD³; Atsushi Taguchi, MD¹; Harukazu Hiraumi, MD, PhD³; Yusuke Okanoue, MD³; Shuya Otsuki, MD³; ¹Kyoto University, Japan; ²University of Occupational and Environmental Health, Japan; ³Tenri Hospital, Japan

Fine Needle Aspiration Cytology (FNAC) is an indispensable diagnostic method in the preoperative evaluation of salivary gland tumors. Reducing sample inadequacy rates and ensuring diagnostic accuracy are crucial for effective FNAC. We developed a compact vibrating device aimed at enhancing cell collection efficiency during FNAC. This device, which uses a standard 5 ml syringe, applies 1 ml of negative pressure while causing the needle tip to oscillate with an amplitude of less than 0.5 mm. This vibration promotes effective cell sampling by improving needle-tip movement, aiding in the collection of adequate cell clusters.

Our previous work showed the effectiveness of this device in FNAC for thyroid tumors, where it significantly reduced sample inadequacy rates and enabled the acquisition of larger cell clusters, which in turn enhanced diagnostic accuracy. Encouraged by these results, we applied this vibrating device to FNAC of salivary gland tumors and compared its performance against permanent pathology to assess diagnostic accuracy.

This study includes 327 FNAC procedures performed on patients with parotid and submandibular gland tumors at our institution between September 2019 and September 2023. Among these, 116 cases that underwent subsequent surgery allowed direct comparison between FNAC and permanent pathological findings. In this study, the sample inadequacy rate was found to be 4.9%, while the rate of diagnostically challenging cases was 4.0%. During FNAC, we employed rapid on-site cytology evaluation to decide if re-sampling was needed, resulting in a re-examination rate of 17.1% and an average puncture count of 1.21 per case.

In the cohort of 116 surgically confirmed cases, 99 cases were diagnosed as benign tumors, and 17 cases were malignant. The overall accuracy of FNAC using our vibrating device reached 95.1%. When focusing on malignant cases, the sensitivity was 76.9%, and the specificity was 97.8%. These values are comparable to existing data from other FNAC methods; however, our device showed an advantage in achieving a lower inadequacy rate. This suggests that vibrating-assisted FNAC could provide a more reliable preoperative diagnostic tool for salivary gland tumors, reducing the likelihood of non-diagnostic or insufficient samples.

In conclusion, our findings underscore the utility of the vibrating device in FNAC, particularly for salivary gland tumor diagnosis. The device not only reduces the rate of inadequate samples but also provides a dependable diagnostic accuracy comparable to traditional methods. We are currently developing a new version of this vibrating device, aiming to make it available as a commercial medical device in various countries including USA, Korea, Japan, Taipei, and Euro. This innovation in FNAC technology may thus represent a valuable advancement in the preoperative diagnosis of head and neck tumors, offering a practical means to enhance sample quality and reduce the need for multiple attempts or repeat procedures.

 

 

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