Cytopathology
Ultrasound guided fine needle aspiration (USFNA)
Technique of ultrasound scanning

Author: Joe D. Jakowski, M.D., Susan Meanor, R.D.M.S., R.T. (see Authors page)

Revised: 6 February 2018, last major update March 2013

Copyright: (c) 2002-2018, PathologyOutlines.com, Inc.

PubMed Search: Technique of ultrasound scanning [title]

Cite this page: Jakowski, J. D.; Meanor, S. Technique of ultrasound scanning. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/cytopathologyusfnascanning.html. Accessed October 18th, 2018.
Definition / general
  • Two patient identifiers (e.g. name and DOB) and site of US scan should be entered into US machine prior to beginning the study
  • Apply coupling gel to transducer footprint or to skin of patient
  • Presence of coupling gel on patient's skin makes for a very slippery surface (but may aid in physical examination of small or ill defined palpable targets), so optimal US scanning technique will be needed
  • Proper stabilization of US transducer on patient's skin is key to good US scanning technique, acquiring a quality sonographic image, and for obtaining a successful USFNA:
    • Do not be afraid to make physical contact with patient and get coupling gel on your hands during scanning
    • Hold the transducer like a pencil with the first three fingers of your dominant hand
    • The ring, little finger, and heel of your hand are then free to stabilize the transducer on the patient's skin
    • With properly stabilization of the transducer during scanning:
      • It lessens the need for pressure to keep the transducer in place
      • The patient will be more comfortable
      • Your hand is less likely to fatigue
  • Apply steady firm pressure to transducer while scanning to maintain full contact of the transducer footprint with patient's skin to eliminate air at this interface
  • Check for proper orientation of US transducer with US display screen and with patient (e.g. right versus left and cranial versus caudal)
  • Image the contralateral side for comparison when necessary to identify a difficult target for USFNA
  • Once the target lesion for USFNA is identified:
    • Obtain complete US views and dimensions in two perpendicular planes (e.g. transverse and longitudinal; Length x Width x Height)
    • Obtain skin to lesion distance measurements
    • Assess vascularity using color or power Doppler
    • Demonstrate any relevant surrounding anatomical landmarks
  • Each USFNA needle placement may be documented using the cineloop feature or captured as a static image
  • Save, annotate, and store images (e.g. PACS system) as necessary
Clinical images

Images hosted on PathOut server:
Missing Image

Holding transducer