Do tumor characteristics predict risk of malignancy in thyroid nodules with indeterminate cytology?

The use of ultrasonography-guided, fine-needle aspiration cytology (FNAC) has enhanced the preoperative characterization of thyroid nodules and reduced the need for diagnostic surgeries. However, complete preoperative characterization is not yet possible for patients with an indeterminate FNAC result. Here, results are discussed from a retrospective study by Banks et al. that aimed to refine preoperative risk assessment of thyroid cancer in patients with indeterminate FNAC results. The authors found that patients' age, nodule size and specific cytological diagnoses were all associated with thyroid malignancy. These variables were used to construct a diagnostic predictor model. The study by Banks et al. provides general guidance for clinicians who need to estimate thyroid cancer risk for patients with indeterminate FNAC results. Refinements in risk assessment for thyroid malignancy might help to individualize care of these patients; however, the results also underscore the need for enhanced diagnostic methods.