title: Endocrine surgeon-performed US guided thyroid FNAC is accurate and efficient.
abstract: BACKGROUND
  Ultrasound guided fine needle aspiration cytology (US-FNAC) is a key diagnostic technique used to assess thyroid nodules. This procedure has been the domain of radiologists, but it is increasingly performed by endocrine surgeons. In the present study we aimed to assess the accuracy and clinical efficiency of US-FNAC performed by endocrine surgeons.
  
  
  METHODS
  This study was a retrospective review of consecutive patients in a 3-year period who underwent US-FNAC performed by endocrine surgeons and radiologists. Medical records, cytology results, and surgical pathology results were collected and analyzed.
  
  
  RESULTS
  A total of 576 US-FNAC were performed on 402 patients during the study period. The endocrine surgeons and radiologists performed 299 and 277 US-FNAC, respectively. The FNAC inadequacy rate was 5.3 % for the endocrine surgeons and 9.3 % for the radiologists (p = 0.05). For thyroid cancer, the sensitivity, specificity, and false negatives of the US-FNAC for the endocrine surgeons was 87 %, 98 %, and 3 %, respectively while that for the radiologists was 88 %, 95 %, and 3.5 %, respectively. Patients with thyroid cancer had a shorter time to surgery in the endocrine surgeons' group (mean 15.3 days) compared to the radiologists' group (mean: 53.3 days; p = 0.01).
  
  
  CONCLUSIONS
  US-FNAC performed by an experienced endocrine surgeon is accurate and allows efficient surgical management for patients with thyroid cancer.
authors.affiliation: Department of Surgery, Endocrine Surgery Unit, Royal Melbourne Hospital, University of Melbourne, Melbourne, VIC, Australia. dalazawi@rcsi.ie
authors.forename: Dhafir
authors.initials: D
authors.lastname: Al-azawi
authors.forename: G Bruce
authors.initials: GB
authors.lastname: Mann
authors.forename: Rodney T
authors.initials: RT
authors.lastname: Judson
authors.forename: Julie A
authors.initials: JA
authors.lastname: Miller
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044963:Biopsy, Fine-Needle / Q000379:methods*; D002983:Clinical Competence; D004704:Endocrinology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D018709:Statistics, Nonparametric; D015996:Survival Rate; D016606:Thyroid Nodule / Q000000981:diagnostic imaging / Q000473:pathology*; D018084:Ultrasonography, Interventional; D000078329:Workforce