Risk of TIRADS-based inappropriate FNAC in autonomous thyroid nodules is clinically negligible
Authors' conclusion
Inappropriate FNACs in AFTNs are primarily observed in patients with low TSH and large AFTN. Since these cases typically undergo scintigraphy, the risk of TIRADS-based UN-FNAC is clinically negligible. There is no need for integrating other imaging procedures into the TIRADS model.
Study context
- Population
- Patients with autonomously functioning thyroid nodule (AFTN) diagnosed on scintigraphy, assessed by ACR-TIRADS; excluded prior AFTN treatment, medications or supplementation affecting thyroid function, or multiple AFTNs
- Participants
- 48 AFTNs
- Outcome
- Appropriateness of TIRADS-based FNAC indication in AFTNs
Main finding
As reported in the abstract
FNAC indication according to TIRADS
- AFTNs with FNAC indication according to TIRADS
- 37.5%
- FNAC indication rate significantly higher with TSH <0.4 mIU/L than in other cases
- P = 0.0078
Observational data: associations, not effects.
Further findings
Predictors of unnecessary FNAC
- Most accurate TSH cut-off associated with UN-FNAC
- ≤ 0.41 mIU/L
- Most accurate AFTN size associated with UN-FNAC
- > 22 mm
- TSH as independent predictor of UN-FNAC (multivariate), OR
- 6.65
- Nodule size as independent predictor of UN-FNAC (multivariate), OR
- 6.46
- FNAC indication rate according to these data
- 4.16%
- Multivariate analysis
Original publication
Risk of TIRADS-based inappropriate FNAC in autonomous thyroid nodules is clinically negligible. Eur Thyroid J. Published 29 July 2024. doi:10.
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