Observational studyJournal of endocrinological investigation2025
Clinical management of indeterminate thyroid nodules needs to be revisited. New evidence for a personalized approach to the problem.
Observational study in Journal of endocrinological investigation, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Observational
- Ultrasound Pattern of Indeterminate Thyroid Nodules with Prevalence of Oncocytes.Journal of clinical medicine · 2025Article
- Evaluation of the Necessity of Repeat Biopsy in Patients with Thyroid Nodules Classified as Atypia of Undetermined Significance (AUS) Based on Fine-Needle Aspiration Biopsy Results.Medicina (Kaunas, Lithuania) · 2025Article
- Malignancy risk in AUS thyroid lesions: comparison between FNA and CNB with implications for NIFTP diagnosis.Frontiers in endocrinology · 2025Article
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Authors and funding
15 authors.
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No grant is acknowledged in the PubMed record.
Abstract
purposeThyroid nodules diagnosed by fine needle aspiration cytology (FNAC) as TIR3A or Class III subgroup "other types of atypia" (indeterminate thyroid nodules - ITNs), are the only ones without a unique clinical action indicated for management. This leads to multiple FNAC repetitions (FNAC-reps) and lifelong follow-up, with huge consumption of time and resources. The aims of the study were to inquire the usefulness of repeating FNAC in ITNs and perform an evaluation of a long-term follow-up of a large cohort of ITNs.
methodsThe study was conducted in two Italian high-volume tertiary centres. We selected patients who underwent the first FNAC with subsequent diagnosis of ITN in a centre involved and who then repeated it in the same institute.
resultsWe included 506 patients. The FNAC-rep determined the "change in management indications" (CMIs) in 30 cases. The binomial test showed that this proportion was not significant (p 0.36). The factors related to CMIs were age (OR = 0.97; 95%CI = 0.95-0.99; p = 0.04), margins (OR = 5.6; 95%CI = 1.7-18.1; p = 0.004), and echogenicity (hypoechoic vs. isoechoic: OR = 5.2; 95%CI = 1.87-14.5; p = 0.002| hypoechoic vs. iso-anechoic: OR = 5.9; 95%CI = 1.32-26.2; p = 0.02). Follow-up of cases without CMIs showed that 20 of 476 cases required surgery. Of these, only four were malignant and all occurred within the first 8 years of observation.
conclusionsThe study demonstrated that FNAC-rep is useless for the most of cases, hence it should only be considered for young adults having nodules with suspicious characteristics. Furthermore, a 10-year follow-up for ITNs is safe enough rather than a long-life follow-up.
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