Optimal timing of repeat thyroid fine-needle aspiration biopsy

Area of Science:

• Pediatric Endocrinology
• Diagnostic Cytopathology
• Surgical Oncology

Background:

• Thyroid nodules are common in children and adolescents, requiring accurate diagnosis.
• Fine-needle aspiration (FNA) biopsy is a key diagnostic tool, but repeat procedures are sometimes necessary.
• Optimal timing for repeat FNA biopsies in pediatric patients remains debated.

Purpose of the Study:

• To determine the ideal interval for repeat thyroid FNA biopsies in pediatric patients.
• To assess the impact of repeat FNA biopsy timing on final pathological diagnosis.
• To refine guidelines for managing pediatric thyroid nodules.

Main Methods:

• Retrospective single-center study of 99 pediatric patients with thyroid nodules.
• Analysis of thyroid ultrasonography (USG) and FNA biopsy data from 2013-2023.
• Recorded intervals between FNA biopsies and compared with surgical cytology results.

Main Results:

• Initial FNA results showed 46.5% benign, 24.2% nondiagnostic, and 5.1% malignant nodules.
• A false-negative rate of 6.5% was observed for benign initial FNA cytology.
• Early repeat FNA (<3 months) for nondiagnostic nodules did not alter diagnostic yield.

Conclusions:

• Repeat FNA biopsy for nondiagnostic nodules with suspicious USG findings should be performed within 3 months.
• Repeat FNA biopsy for benign nodules with suspicious USG findings should be performed within 6 months.
• Timely repeat FNA biopsies facilitate earlier surgical intervention, particularly for malignant cases.