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- Does needle size matter during aspiration?
Diagnostic quality of ultrasound-guided fine-needle aspirates samples from the canine liver and spleen is not significantly affected by using 22-, 23-, and 25-gauge needles
Background: There is some controversy regarding which FNA technique and needle size yields the most diagnostic samples.
Study: This was a prospective, analytical study that enrolled 94 dogs for splenic FNA and 116 dogs for hepatic FNA and seeks to compare the diagnostic quality of ultrasound-guided FNA cytological samples of canine liver and spleen using different needle sizes (22-, 23-, and 25-gauge). The samples were evaluated by two board-certified veterinary clinical pathologists using a four-tier grading system.
Methods: The authors used a nonaspiration technique with four needle passes for each organ and each needle size. The order of needle size was randomized. The slides were stained with modified Wright stain and scored for cellularity, blood contamination, cell preservation, and diagnostic quality.
Results: The authors found no significant differences in diagnostic quality between different needle gauge sizes for both spleen and liver. However, they found less blood contamination in hepatic FNA using 25-gauge needles compared to 22-gauge needles. They also found slightly better cell preservation and more diagnostic samples in splenic FNA using 25-gauge needles compared to 22- and 23-gauge needles.
Limitations: The authors acknowledged several limitations, such as the inter-operator variability, the exclusion of focal lesions and bleeding disorders, the use of only three needle sizes, and the lack of histopathological confirmation and variety of cytological diagnoses.
Conclusions: The authors concluded that needle gauge did not significantly affect the diagnostic quality of canine hepatic and splenic FNA, but suggested that 25-gauge needles may produce slightly better-quality samples. They recommended further studies to compare different FNA techniques and needle sizes.
Photomicrographs of different degrees of cellularity, blood contamination and cell preservation in splenic (left, A–C) and hepatic (right, D–F) aspirates. Spleen: (A) high cellularity (3), low blood contamination (1), excellent cell morphology preservation (3); (B) moderate cellularity (2), moderate blood contamination (2) and good cell morphology preservation (2); (C) low cellularity (1), marked blood contamination (3) and fair cell morphology preservation (1). Liver: (D) high cellularity (3), mild blood contamination (1), excellent cell morphology preservation (3); (E) moderate cellularity (2), moderate blood contamination (2) and good cell morphology preservation (2); (F) low cellularity (1), marked blood contamination (3) and fair cell morphology preservation (1). Modified Wright stain in 200× (A–C) and 100× (D–F) magnification.
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