Evaluation of a dedicated ultrasound fine needle aspiration service for thyroid nodules.

Abstract

Introduction: We studied whether: (1) a quality-focused thyroid fine needle aspiration (FNA) service reduced the non-diagnostic (ND) rate of FNA; (2) the implementation of thyroid FNA selection criteria resulted in higher proportion of Bethesda V and VI cytology and malignant histopathology; and (3) impact of radiologist's level of experience on ND rates. Method(s): The imaging and pathology computer databases were retrospectively searched for all patients who had thyroid FNAs at our hospitals from July 2004 to December 2016. Result(s): Three hundred thirty-eight and 609 patients in pre-thyroid and post-thyroid service groups, respectively, were evaluated. The ND rate of 36.7% in pre-thyroid service was significantly higher than post-thyroid service at 14.6% (p < 0.0001). The rates of Bethesda V and VI cytology in the pre-thyroid service group did not differ significantly from the post-thyroid group (p = 0.266; p = 0.069). There was no significant difference in the histopathologic malignancy rates between the two groups (p = 0.531). There was no significant difference in the ND rates of radiologists with varying experience (p = 0.873). Discussion(s): On-site cytology improved the ND rate of ultrasound-guided thyroid FNA. Implementation of FNA selection criteria did not alter the rates of Bethesda V and VI cytology and malignant histopathology. The experience of radiologists did not significantly influence ND rates.Copyright © 2018 Australasian Sonographers Association