Thyroid Fine-Needle Aspiration<subtitle>Does Case Volume Affect Diagnostic Yield and Interpretation?</subtitle>

Abstract

Case volume significantly influences the pathologic interpretation of thyroid FNA, as low-volume pathologists report more atypical and fewer benign FNA results. Case volume did not have a significant impact on diagnostic yield, because thyroid FNAs performed by low-volume clinicians did not result in more frequent nondiagnostic results compared with those performed by high-volume clinicians.

Variation of cytopathologists' use of the indeterminate diagnostic categories “atypical” and “suspicious for malignancy” in the cytologic diagnosis of solid pancreatic lesions on endoscopic ultrasound‐guided fine‐needle aspirates

“…This suggests that exposure to a certain minimum annual volume of pancreatic aspirates (about 30/year) may be useful to increase the confidence level and diagnostic certainty of cytopathologists. Previous studies performed on thyroid FNAs have similarly shown that the rates of indeterminate diagnoses do not correlate with the years of experience of the pathologists or overall volume of thyroid FNAs evaluated, but that pathologists exposed to low annual volumes (<50) of thyroid FNAs were more likely to diagnose them as atypical and less likely as benign compared to pathologists who diagnosed over 50 thyroid FNAs …”

Analyzing the impact of molecular testing on the cytological diagnosis of thyroid nodules: Insights from our institution's experience

“…There has been some speculation that this is occurring in multiple practice settings [25][26][27] as well as criticism of reproducibility of results, specifically with respect to AUS. [27][28][29] To discourage overuse of the AUS category, several authors have proposed an AUS:M as a quality monitor for cytopathology laboratories and individual cytopathologists. [30][31][32] This study revealed a statistically significant increase in indeterminate diagnoses, specifically AUS, with the implementation of the reflex molecular testing strategy for performing molecular testing on almost all TBS class III and IV samples.…”

“…With increased utilization of molecular testing on indeterminate specimens, there may represent a risk of overdiagnosing nodules that might have best been classified as benign. There has been some speculation that this is occurring in multiple practice settings [25][26][27] as well as criticism of reproducibility of results, specifically with respect to AUS. [27][28][29] To discourage overuse of the AUS category, several authors have proposed an AUS:M as a quality monitor for cytopathology laboratories and individual cytopathologists.…”

Changes in Diagnostic Performance of Thyroid Cancer Screening before and after the Korean Thyroid Imaging Reporting and Data System Revision

“…Technological advances and the training level of physicians may have influenced the efficiency of thyroid cancer screening. The imaging resolution of thyroid ultrasound has gradually improved as well as the skills of sonographers and FNA performers, owing to the increasing number of screening cases each year [ 15 ].…”