AB251. SOH26AB_0457. Evolving trends in fine-needle aspiration of thyroid nodules: a retrospective analysis
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AB251. SOH26AB_0457. Evolving trends in fine-needle aspiration of thyroid nodules: a retrospective analysis

Huilun Huan1, Nicole Coffey1, Orla Smith2, David Gibbons2, Ronan Killeen3, Ruth Prichard1

1Department of Surgery, St. Vincent’s University Hospital, Dublin, Ireland; 2Department of Histopathology, St. Vincent’s University Hospital, Dublin, Ireland; 3Department of Radiology, St. Vincent’s University Hospital, Dublin, Ireland

Background: Thyroid nodules are common, yet only a minority harbour clinically significant malignancy. Recent evidence and updated guidelines support higher thresholds for fine-needle aspiration (FNA), guided by structured ultrasound risk stratification systems. This study aimed to evaluate whether evolving evidence-based practices have influenced FNA utilisation at a single institution.

Methods: A retrospective review was conducted of 100 consecutive thyroid FNAs performed in 2019 and 2024. Extracted variables included demographics, ultrasound indication, nodule size, cytological classification, repeat FNA rates, and surgical outcomes. Comparative analysis was used to assess changes in biopsy selection and diagnostic yield.

Results: Across both cohorts, 100 FNAs were analysed per year. In 2019, FNAs were performed on 98 patients (75 female; mean age, 58 years). Indications for FNAs demonstrated wide distribution across ultrasound-based risk categories, with only 32% representing high-risk [Thyroid Imaging Reporting and Data System (TI-RADS) 4–5] nodules. In 2024, 100 FNAs in 94 patients (81 female; mean age, 55 years) showed a marked shift toward biopsying higher-risk lesions, with TI-RADS 4–5 comprising 57% of documented indications. Stratified risk documentation also improved, with undocumented cases falling from 36% to 12%. Mean nodule size decreased slightly (32 to 29 mm). Cytological adequacy improved, with non-diagnostic samples decreasing from 16 to 2, while benign and indeterminate rates remained proportionally similar. Surgical intervention declined from 21 to 15 cases, yet the malignant yield was identical in both cohorts (six cancers each).

Conclusions: Between 2019 and 2024, practice patterns demonstrate a shift toward biopsying higher-risk nodules, with markedly improved documentation of ultrasound-based indications. This was accompanied by fewer surgical interventions, while malignancy detection remained stable. These findings indicate more selective, guideline-aligned FNA utilisation that enhances efficiency without compromising diagnostic yield.

Keywords: Fine-needle aspiration (FNA); thyroid nodules; Thyroid Imaging Reporting and Data System grading (TI-RADS grading); thyroid cytology; thyroid cancer

Acknowledgments

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Footnote

Funding: None.

Conflicts of Interest: The authors have no conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

doi: 10.21037/map-26-ab251
Cite this abstract as: Huan H, Coffey N, Smith O, Gibbons D, Killeen R, Prichard R. AB251. SOH26AB_0457. Evolving trends in fine-needle aspiration of thyroid nodules: a retrospective analysis. Mesentery Peritoneum 2026;10:AB251.

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