Introduction: Thyroid FNAB is the gold standard to discriminate malignant from benign thyroid nodules. However, inadequate cytology ranges from 1 to 20% (up to 33.6%) in different settings and could depend on several factors, including the operators skills.
Aim: To evaluate the effect of operators experience on US-FNAB diagnostic adequacy we reviewed 7029 US-FNABs performed from January 2006 to March 2009.
Materials and Methods: US-FNABs were performed by 15 different operators; of them four had more than 5 years of experience, and 11<2 years of experience. All clinical data of the patients were collected and analyzed using the MoCyThy DATABASE, which is the part of the institutional database ENDOBASE (based on the MyQ16L open source technology) devoted to store data of all institutional US-FNABs.
Results: Five hundred twenty one (7.41%) of 7029 US-FNABs resulted inadequate. The inadequate sample rate was higher in the group of less experienced (<2 years) than in the group of more experienced (>5 years) physicians (9.05 and 6.98% respectively; P=0.009 at χ2 test). Furthermore, US-FNABS in the hands of less experienced operators resulted in a higher number of slides in comparison with the more experienced operators (11±0.081 vs 8±0.048; P<0.001 at KruskalWallis test). The number of slides, however, was not significantly related to sample inadequacy (P=0.059 at KruskalWallis).
Conclusions: The experience of the operators is determinant for a better outcome in terms of lower inadequate sample rates and a lower number of slides needed to obtain a diagnostic outcome. In clinical practice, these results point out the impact of the operators experience on US-FNAB procedure, suggesting that US-FNABS is cost-effective and less time-consuming in skilled hands.
Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.
Funding: This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.
05 - 09 May 2012
European Society of Endocrinology