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Using what we already have: Optimizing information from ultrasound and fine needle aspiration biopsy for decision making in thyroid nodular disease

      Thyroid nodules present an interesting and challenging conundrum to the clinician. The prevalence of these nodules in the general population is high, and partially dependant on the veracity with which they are sought (ranging from 4 to 7% on clinical exam all the way up to as high as 67% on neck ultrasound). Fortunately, the rate of malignancy remains relatively low. Given this, the ideal workup of these nodules would accurately identify malignant lesions requiring treatment while limiting the risks of tests, procedures, and operations in those that ultimately prove to be benign. As noted by the authors, fine needle aspiration biopsy (FNAB) is limited by diagnostic uncertainty associated with indeterminate and non-diagnostic results. Consequently, patients may be subjected to repeated biopsies and diagnostic surgery that ultimately prove to be non-therapeutic while maintaining their inherent risks.
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      References

        • Dickey Matthew Verne
        • Nguyen Anne
        • Wiseman Sam M.
        Cancer risk estimation using American College of Radiology Thyroid Imaging Reporting and Data System for cytologically indeterminate thyroid nodules.
        Am J Surg. 2022; 224: 653-656https://doi.org/10.1016/j.amjsurg.2022.02.061