Materials and Methods
The US-FNA service includes (1) an FNA procedure to be performed by a cytopathologist under US guidance; (2) onsite adequacy evaluation and diagnosis to be done by the same cytopathologist; and immediate patient consultation and sample triaging carried out by the same cytopathologist in an FNA suite within the department of Pathology. The FNA suite including a procedure room equipped with a portable US machine, an exam/procedure table, a mobile cabinet with FNA supplies, a counter with sink, and a reception room with waiting area is set-up.
The establishment of the US-FNA service is successful. There is an incremental growth of the service over the first 8 months. Among the 114 cases performed during the first 8 months, the case type distribution is shown to be 50% thyroid nodules, 33% lymph nodes, 5.5% salivary gland masses, 3.5% breast masses, and 8% soft tissue masses.
The authors’ initial 8 months experience and strategies in setting up a new US-FNA practice in a new institution are discussed to highlight obstacles encountered and approaches that promoted the successful establishment of a new service. A conservative approach, focusing on building partnerships with existing clinical services, can be successfully implemented in most institutions, if appropriate strategies are applied. The main strategy is to ensure that the best interests of patients remain the primary focus and that everything possible is done to improve the quality and effectiveness of patient care by providing the best possible diagnostic US-FNA service, to enable optimal clinical management.