title: Fine-needle aspiration biopsy of thyroid nodules: comparison of diagnostic performance of experienced and inexperienced physicians.
abstract: OBJECTIVE
  To determine whether a difference exists in terms of obtaining adequate cytologic samples from ultrasound-guided fine-needle aspiration cytology (US-FNAC) between experienced and inexperienced physicians in a tertiary referral center.
  
  
  METHODS
  In a prospective design, all patients with thyroid nodules of at least 10 mm in diameter were referred for US-FNAC tissue sampling as a part of their diagnostic work-up. Between May 2006 and September 2009, 997 euthyroid patients with 1,320 thyroid nodules were referred for US-FNAC by the attending endocrinologist (experienced physician) or 1 of 2 endocrinology fellows (inexperienced physicians).
  
  
  RESULTS
  Of the 1,320 nodules, 713 biopsy specimens were obtained by the experienced physician and 607 were obtained by the inexperienced physicians. Nodule size was significantly larger in the endocrinologist's group of patients than in the fellows' group of patients (17 mm versus 14 mm, respectively; P<.001). The inadequacy rate of the US-FNAC procedures performed by the experienced physician (22 of 713 thyroid nodules or 3.1%) was significantly lower than for those performed by the inexperienced physicians (102 of 607 thyroid nodules or 16.8%) (P<.001).
  
  
  CONCLUSIONS
  We conclude that, with increasing operator experience, the number of inadequate cytologic specimens generated by US-FNAC procedures is substantially reduced. This limits both direct and indirect costs and also minimizes the risks of possibly unnecessary surgical procedures.
authors.affiliation: Department of Endocrinology and Metabolism, Baskent University Faculty of Medicine, Ankara, Turkey.
authors.forename: Alptekin
authors.initials: A
authors.lastname: Gursoy
authors.forename: Cuneyd
authors.initials: C
authors.lastname: Anil
authors.forename: Betul
authors.initials: B
authors.lastname: Erismis
authors.forename: Semra
authors.initials: S
authors.lastname: Ayturk
mesh_terms: D000328:Adult; D000368:Aged; D044963:Biopsy, Fine-Needle / Q000379:methods*; D003584:Cytological Techniques / Q000191:economics; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016606:Thyroid Nodule / Q000175:diagnosis* / Q000473:pathology