Purpose: Image-guided fine-needle aspiration cytology (FNAC) may be useful as an alternative diagnostic approach to lesions in the head and neck. This study reports on the use of magnetic resonance imaging (MRI)-guided FNAC for diagnostic evaluation of deep lesions in this region.
Materials and methods: This was a prospective study of 12 patients with deep lesions in the head and neck who underwent MRI-guided FNAC at the Shanghai 9th People's Hospital. A 0.2-T open magnet was used for MRI and localization of the 20-gauge MRI-compatible needle. All of the aspirated samples were stained with hematoxylin and eosin and examined by a cytopathologist.
Results: The needle in all 12 cases was displayed on MRI in the central portion of the lesion under the guidance of MRI; 12 of 12 patients (100%) had diagnostic aspirations and none needed open biopsy for more specific histologic interpretation. Six of these 12 patients with tumors (4 malignant, 2 benign) underwent operative treatment with positive postoperative pathologic results. One patient had a diagnosis of inflammation. The diagnostic accuracy was 91.67% (11 of 12), the sensitivity was 85.71% (6 of 7), and the specificity was 100% (5 of 5). There were no false-positive results and 1 false-negative result, for a false-negative rate of 14.29% (1 of 7). All aspiration procedures were well tolerated and without complications.
Conclusions: MRI-guided FNAC is a cost-effective tool for establishing tissue diagnosis as a primary investigative modality. It is helpful and accurate in the diagnosis of deep lesions in the head and neck and in follow-up of patients, thereby avoiding further surgical intervention.