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Non-diagnostic thyroid nodules after application of the Bethesda system: a study evaluating the interval for repeat aspiration for non-diagnostic results

 Jung Hyun Yoon  ;  Eun-Kyung Kim  ;  Jin Young Kwak  ;  Hee Jung Moon 
 Acta Radiologica, Vol.59(3) : 305-312, 2018 
Journal Title
 Acta Radiologica 
Issue Date
Adolescent ; Adult ; Aged ; 80 and over Aged ; Fine-Needle Biopsy ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Thyroid Gland/pathology ; Thyroid Nodule/*diagnosis/*pathology ; Interventional *Ultrasonography ; Young Adult
Bethesda system ; Thyroid ; fine needle aspiration ; non-diagnostic
Background The non-diagnostic category of the Bethesda system has a low malignancy rate; nevertheless, repeat ultrasonography-guided fine needle aspiration (US-FNA) is recommended with no consensus for follow-up intervals. Purpose To investigate whether a six-month time interval for repeat US-FNA is appropriate for non-diagnostic thyroid nodules after applying the Bethesda system. Material and Methods From January 2010 to January 2014, 322 thyroid nodules >/=10 mm with non-diagnostic results on initial US-FNA with any follow-up with US or US-FNA were included (mean age = 52.2 years +/- 12.4). Clinical and US features were compared according to size change (increase, no change, decrease) and follow-up interval (<6 months and >/=6 months after initial US-FNA), and the minimal time interval observed in nodules with size increase on follow-up. The outcome of non-diagnostic nodules according to follow-up interval and size change were evaluated. Results Of the 322 nodules, 13 (4.0%) were malignant and 309 (96.0%) were benign. None of the 82 nodules with decreased size were malignant and 90.2% nodules with decreased size were found after six months. Of 175 nodules with repeat US-FNA, repeat cytology results did not differ significantly between the groups with follow-up US-FNA before and after six months ( P = 0.337). No significant differences were seen in size or extrathyroidal extension among the 13 malignant nodules according to the six-month interval (all P > 0.05), and no lateral lymph node metastasis was present. Conclusion Repeat US-FNA for initially non-diagnostic thyroid nodules can be performed at a six-month interval after initial procedure without tumor progression.
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1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
곽진영(Kwak, Jin Young) ORCID logo https://orcid.org/0000-0002-6212-1495
김은경(Kim, Eun-Kyung) ORCID logo https://orcid.org/0000-0002-3368-5013
문희정(Moon, Hee Jung) ORCID logo https://orcid.org/0000-0002-5643-5885
윤정현(Yoon, Jung Hyun) ORCID logo https://orcid.org/0000-0002-2100-3513
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