Inconclusive cytology results of fine-needle aspiration for thyroid nodules: the importance of strict guideline implementation
Purpose This study investigated whether strict adherence to the Korean Thyroid Imaging Reporting and Data System (K-TIRADS) biopsy indications could reduce inconclusive cytology results and evaluated associated clinical factors. Methods This retrospective study included 2,440 nodules from 2,256 pati...
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Korean Society of Ultrasound in Medicine
2025-07-01
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| Series: | Ultrasonography |
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| Online Access: | http://www.e-ultrasonography.org/upload/usg-24216.pdf |
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| author | Sangwoo Cho Kyunghwa Han Jung Hyun Yoon Vivian Youngjean Park Miribi Rho Jiyoung Yoon Jin Young Kwak |
| author_facet | Sangwoo Cho Kyunghwa Han Jung Hyun Yoon Vivian Youngjean Park Miribi Rho Jiyoung Yoon Jin Young Kwak |
| author_sort | Sangwoo Cho |
| collection | DOAJ |
| description | Purpose This study investigated whether strict adherence to the Korean Thyroid Imaging Reporting and Data System (K-TIRADS) biopsy indications could reduce inconclusive cytology results and evaluated associated clinical factors. Methods This retrospective study included 2,440 nodules from 2,256 patients who underwent initial fine-needle aspiration (FNA) for thyroid nodules from January to December 2022. Inconclusive specimens were defined as Bethesda categories I and III, while conclusive specimens comprised Bethesda categories II, IV, V, and VI. Nodules smaller than the K-TIRADS biopsy threshold were considered FNA not-indicated nodules. Clinical factors included patient age, sex, ultrasound features, nodule size, number of needle passes, and operator experience. Univariate and multivariate logistic regression analyses were performed to assess the associations between clinical factors and inconclusive results. Results Among 2,440 nodules, 900 yielded initial inconclusive biopsy results, while 1,540 provided conclusive results. Independent predictors of inconclusive biopsy results included FNA not-indicated nodules, nodules sized 0 to 5 mm, operator experience of less than 1 year, older age, and K-TIRADS category 4 (P<0.001, P=0.006, P=0.003, P=0.001, and P<0.001, respectively). Among K-TIRADS category 4 nodules, the presence of suspicious ultrasound characteristics was negatively associated with inconclusive biopsy results (P=0.004). Conclusion FNA not-indicated nodules, nodule size of 0 to 5 mm, operator experience of less than 1 year, older age, and K-TIRADS category 4 were factors associated with inconclusive biopsy results. Strict adherence to the K-TIRADS biopsy indications may reduce inconclusive cytology results. |
| format | Article |
| id | doaj-art-5e2934ddfe744212ad0cf0ccce44e014 |
| institution | Kabale University |
| issn | 2288-5943 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Korean Society of Ultrasound in Medicine |
| record_format | Article |
| series | Ultrasonography |
| spelling | doaj-art-5e2934ddfe744212ad0cf0ccce44e0142025-08-20T03:32:24ZengKorean Society of Ultrasound in MedicineUltrasonography2288-59432025-07-0144428529310.14366/usg.242161765Inconclusive cytology results of fine-needle aspiration for thyroid nodules: the importance of strict guideline implementationSangwoo Cho0Kyunghwa Han1Jung Hyun Yoon2Vivian Youngjean Park3Miribi Rho4Jiyoung Yoon5Jin Young Kwak6 Yonsei University College of Medicine, Seoul, Korea Department of Radiology, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, Korea Department of Radiology, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, Korea Department of Radiology, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, Korea Department of Radiology, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, Korea Department of Radiology, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, Korea Department of Radiology, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, KoreaPurpose This study investigated whether strict adherence to the Korean Thyroid Imaging Reporting and Data System (K-TIRADS) biopsy indications could reduce inconclusive cytology results and evaluated associated clinical factors. Methods This retrospective study included 2,440 nodules from 2,256 patients who underwent initial fine-needle aspiration (FNA) for thyroid nodules from January to December 2022. Inconclusive specimens were defined as Bethesda categories I and III, while conclusive specimens comprised Bethesda categories II, IV, V, and VI. Nodules smaller than the K-TIRADS biopsy threshold were considered FNA not-indicated nodules. Clinical factors included patient age, sex, ultrasound features, nodule size, number of needle passes, and operator experience. Univariate and multivariate logistic regression analyses were performed to assess the associations between clinical factors and inconclusive results. Results Among 2,440 nodules, 900 yielded initial inconclusive biopsy results, while 1,540 provided conclusive results. Independent predictors of inconclusive biopsy results included FNA not-indicated nodules, nodules sized 0 to 5 mm, operator experience of less than 1 year, older age, and K-TIRADS category 4 (P<0.001, P=0.006, P=0.003, P=0.001, and P<0.001, respectively). Among K-TIRADS category 4 nodules, the presence of suspicious ultrasound characteristics was negatively associated with inconclusive biopsy results (P=0.004). Conclusion FNA not-indicated nodules, nodule size of 0 to 5 mm, operator experience of less than 1 year, older age, and K-TIRADS category 4 were factors associated with inconclusive biopsy results. Strict adherence to the K-TIRADS biopsy indications may reduce inconclusive cytology results.http://www.e-ultrasonography.org/upload/usg-24216.pdfthyroid nodulefine-needle biopsyultrasonographycytology |
| spellingShingle | Sangwoo Cho Kyunghwa Han Jung Hyun Yoon Vivian Youngjean Park Miribi Rho Jiyoung Yoon Jin Young Kwak Inconclusive cytology results of fine-needle aspiration for thyroid nodules: the importance of strict guideline implementation Ultrasonography thyroid nodule fine-needle biopsy ultrasonography cytology |
| title | Inconclusive cytology results of fine-needle aspiration for thyroid nodules: the importance of strict guideline implementation |
| title_full | Inconclusive cytology results of fine-needle aspiration for thyroid nodules: the importance of strict guideline implementation |
| title_fullStr | Inconclusive cytology results of fine-needle aspiration for thyroid nodules: the importance of strict guideline implementation |
| title_full_unstemmed | Inconclusive cytology results of fine-needle aspiration for thyroid nodules: the importance of strict guideline implementation |
| title_short | Inconclusive cytology results of fine-needle aspiration for thyroid nodules: the importance of strict guideline implementation |
| title_sort | inconclusive cytology results of fine needle aspiration for thyroid nodules the importance of strict guideline implementation |
| topic | thyroid nodule fine-needle biopsy ultrasonography cytology |
| url | http://www.e-ultrasonography.org/upload/usg-24216.pdf |
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