Name of the Procedure:

Oncology (Thyroid), mRNA, Gene Expression Analysis of 10,196 Genes utilizing Fine Needle Aspirate (FNA)

• Common Names: Thyroid mRNA Analysis, Thyroid Gene Expression Profiling
• Technical Terms: Fine Needle Aspiration (FNA), Gene Expression Analysis, Algorithmic Categorical Reporting

Summary

This procedure involves analyzing gene expression in thyroid cells collected through a fine needle aspiration to evaluate for cancer. The analysis covers over 10,000 genes and uses an algorithm to categorize the results as benign or suspicious for malignancy.

Purpose

The procedure is used to diagnose or rule out thyroid cancer. It aims to provide a comprehensive molecular profile of thyroid nodules to guide treatment decisions, potentially avoiding unnecessary surgeries.

Indications

• Presence of thyroid nodules detected via ultrasound or physical examination
• Previous indeterminate results from traditional Fine Needle Aspiration Cytology
• Patients at risk of thyroid cancer
• Previous history or family history of thyroid cancer

Preparation

• Generally, no special preparation such as fasting is required.
• Patients should inform their doctor about all medications they are taking.
• Certain blood tests may be conducted to evaluate general health prior to the procedure.

Procedure Description

1. The patient typically lies flat on a table.
2. The neck is cleaned with antiseptic and local anesthesia is administered to numb the area.
3. Using ultrasound guidance, a fine needle is inserted into the thyroid nodule.
4. A small sample of cells is aspirated into the needle.
5. The collected sample is sent to a lab where mRNA expression of 10,196 genes is analyzed.
6. An advanced algorithm processes the gene expression data and classifies the nodule as benign or suspicious.

Duration

The fine needle aspiration typically takes about 30 minutes, with analysis results available within days to a week.

Setting

This procedure is performed in an outpatient clinic or a hospital setting.

Personnel

• Endocrinologist or Radiologist
• Nurse or Medical Assistant
• Pathologist and Molecular Geneticist (for lab analysis)

Risks and Complications

• Common: Minor bruising, tenderness, or swelling at the needle site
• Rare: Infection, bleeding, or very rarely, injury to nearby structures
• Management: Complications are usually minor and managed with conservative treatments like over-the-counter pain relievers.

Benefits

• High accuracy in determining the nature of a thyroid nodule
• Reduces the likelihood of unnecessary surgeries for benign nodules
• Helps in making informed decisions about the need for surgery or further monitoring

Recovery

• Patients can usually return to normal activities immediately after the procedure.
• Avoid heavy lifting or strenuous activity for 24 hours.
• Follow-up appointments are typically scheduled to discuss the results.

Alternatives

• Traditional Fine Needle Aspiration Cytology: Less detailed, higher chance of indeterminate results.
• Surgical Biopsy: More invasive, requiring longer recovery.
• Watchful waiting with regular imaging and monitoring.

Patient Experience

• The patient may feel a slight pinch or pressure during the needle insertion.
• After the procedure, minor soreness at the needle site can be managed with ice packs or pain relief medications.
• Anxiety may be experienced while waiting for results; supportive care and counseling can be helpful.