Risk of malignancy in thyroid nodules selected for fine needle aspiration biopsy based on ultrasound risk stratification

Abstract Aim Risk stratification of thyroid nodules based on ultrasound scan (USS) features using the TIRADS- or U-scale has been widely adopted. However, management decisions for patients whose work-up provide conflicting information, remains challenging. The aim this study was to assess rate malignancy among those with suspicious cytology after USS-evaluation. Methods Retrospective review clinical, radiological and pathological data regarding presenting a nodule. Results Between January 2018 December 2020, total 214 underwent surgery nodule(s) fine-needle aspiration (FNA) report either (Thy3–4) diagnostic (Thy5) malignancy. appearance USS stratified TIRADS-scale, select needing FNA-assessment characterise palpable nodules. For Thy3a-cytology, risk remained low, irrespective USS-appearance (2/15 in TIRADS2-3 versus 2/9 TIRADS 4-5). Thy3f-cytology, higher if also (11/75 17/69 4-5, p=0.03). High-risk (TIRADS 4-5) presence suspicious/diagnostic (Thy4-5) had 95% positive predictive value (40/42) Future collection should when is malignant 5) yet benign (Thy2). Conclusion performance FNA cohort corroborates published data. Until genetic panels will complement assessment Thy3-cytology, lobectomy necessary, as limited ability increase yield