As a part of our ongoing efforts to best serve the Greater Nashua Community, St. Joseph Hospital proudly offers Ultrasound Guided Fine Needle Aspiration. Mikhail Signalov, DO, is one of the only providers in New Hampshire that is able to perform this procedure, and holds an Endocrine Certification in Neck Ultrasound (ECNU). This certification requires extensive knowledge and training in ultrasonography to be able to perform consultations and diagnostic evaluations for thyroid and parathyroid disorders.
Mikhail Signalov, DO, performs Ultrasound Guided Fine Needle Aspiration in-office under ultrasound guidance. In the majority of cases, local anesthesia is not necessary and patient discomfort is minimal. The procedure is performed with very thin (27 Gage) needles, which are used for obtaining a thyroid cells for further analysis. In order to receive accurate results, he will normally use at least four needles to evaluate one nodule. As the needles are visualized on the ultrasound throughout the entire procedure, complications are extremely rare. A study conducted at Mayo Clinic based on 585 procedures indicated that in 90% of patients level of discomfort was only 2 (on a scale of 1-10) regardless of using or not using local anesthetics.
- Avoid Aspirin or Ibuprofen like medications (Advil, Aleve, Motrin, etc.) for at least 5 days prior to procedure
- Avoid any makeup/lotions
- V-neck shirt is preferred for procedure
- Avoid any blood thinners for at least 24 hours after the procedure (please notify office in advance if you are currently on any blood thinners)
The risk of having an Ultrasound Guided Fine Needle Aspiration are minimal can include local soreness, bruising, bleeding, and infection. One of the most common issues is non-diagnostic results, which can happen if not enough cells are collected during the initial sampling. However, this issue is extremely rare and is accounted for less than 5% of biopsies. Our specialists recommend that you can return to normal daily immediately after the procedure. If you develop any complications such as worsening pain, swelling, increased redness of the biopsy site, signs of skin infection or irritation, please contact our office immediately.
After the Ultrasound Guided Fine Needle Aspiration is performed, the specimens obtained are sent to Outpatient Pathology Associates (OPA) in California, our leading experts in thyroid cytopathology. Cytology results are usually reported within 7-10 business days. In most cases, the pathologist is able to provide a define diagnosis of the nodule, in which Mikhail Signalov, DO, will review and configure a proper treatment plan. However, in about 25% of cases, results come back as indeterminate (ambiguous). The risk of malignancy associated with indeterminate cytology can be up to 30%.
In the past, patients who were diagnosed with indeterminate nodules required a repeat Ultrasound Guided Fine Needle Aspiration or surgical resection of at least half of the thyroid gland. With St. Joseph Hospital’s advanced technology, genetic analysis can be performed to avoid unnecessary surgery the risks that come along with it. In cases where no mutations were found, molecular genetics suggest minimal (usually 3%) risk of cancer and instead of surgery, allows for patients to continue conservative follow ups with providers.