Endocrine Abstracts

Introduction: Ultrasound guidance is now standard for improving diagnostic accuracy in thyroid FNACs. Its success depends on operator skill, emphasizing the need for trained personnel to enhance sample quality. Although generally safe and minimally invasive, it requires technical expertise and awareness of limitations. Factors such as lesion characteristics, needle localization, sampling methods, and the number of samples can significantly affect outcomes.

Aims of the Study: High Thy 1 rates (insufficient samples) lead to increased patient visits, anxiety, repeat procedures, and strain on healthcare systems. Audits conducted from January to June 2023 assessed aspirator performance at South Tees Trust, identifying those with FNAC specimen rates above 15% for further training, following RCP 2021 guidance.

Results: Of the 234 Thyroid aspirates, 91 were Thy 1. 8.79 % underwent two FNAC ‘s in same setting. D, an advanced practitioner, performed under the supervision of Aspirator C. Nearly 60% of cases were right-sided. Larger nodules had higher inadequacy rates, while smaller nodules had the lowest. Nearly 70% required repeat FNAC, with over 50% returning a Thy 1, and 10% underwent surgery, revealing two malignancies. Continuity of care was a concern, as 8% lacked follow-up and only 10% were referred to multidisciplinary teams.

Conclusion: Assessing inadequacy rates in FNAC procedures is essential for improving diagnostic accuracy. Findings stress the need for standardized clinician training and auditing to enhance sample adequacy, address healthcare resource strains, and improve patient care. Further analysis of inadequacy rates is ongoing, identifying critical areas for improvement in FNAC methodology.

Limitations: Reliance on a single individual for many FNACs may introduce bias due to skill variability, higher case volume, workload fatigue, and lack of cross-validation.