title: Evaluation of clinical presentation and referral indications for ultrasound-guided fine-needle aspiration biopsy of the thyroid as possible predictors of thyroid cancer.
abstract: Whether initial clinical presentation and thyroid ultrasonography referral indications can significantly predict malignant/suspicious for malignancy (Bethesda System for Reporting Thyroid Cytopathology [Bethesda] V/VI) thyroid ultrasound-guided fine-needle aspiration (FNA) cytology results is unknown.
  
  
  
  Between January 2010 and May 2014, we performed 705 thyroid ultrasound-guided FNA biopsies, according to the American Thyroid Association (ATA) guidelines. Univariate analysis was used to identify significant predictors for Bethesda V/VI thyroid ultrasound-guided FNA cytology, including age, sex, imaging modality, thyroid dysfunction, neck pain, breathing difficulties, dysphagia, odynophagia, fatigue, lateral cervical mass, parotid mass, and hyperparathyroidism.
  
  
  
  Sixty percent of patients were referred to thyroid ultrasound-guided FNA because of thyroid incidentalomas and 40% because of palpable thyroid nodules found on physical examination. Only positron emission tomography (PET)-CT emerged as being a significant predictor for Bethesda V/VI thyroid ultrasound-guided FNA cytology (odds ratio [OR] = 5.64; 95% confidence interval [CI] = 1.16-27.33; p = .03).
  
  
  
  Patient symptomatology and initial clinical thyroid ultrasound-guided FNA referral indications cannot predict the nature of thyroid nodules. © 2015 Wiley Periodicals, Inc. Head Neck 38: E991-E995, 2016.
authors.affiliation: Department of Otolaryngology Head and Neck Surgery and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
authors.forename: Sara
authors.initials: S
authors.lastname: Abu-Ghanem
authors.affiliation: Department of Otolaryngology Head and Neck Surgery, Kaplan Medical Center, Hadassah School of Medicine, Hebrew University, Rehovot, Israel.
authors.forename: Oded
authors.initials: O
authors.lastname: Cohen
authors.affiliation: Department of Otolaryngology Head and Neck Surgery, Kaplan Medical Center, Hadassah School of Medicine, Hebrew University, Rehovot, Israel.
authors.forename: Anna
authors.initials: A
authors.lastname: Lazutkin
authors.affiliation: Department of Otolaryngology Head and Neck Surgery and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
authors.forename: Yasmin
authors.initials: Y
authors.lastname: Abu-Ghanem
authors.affiliation: Department of Otolaryngology Head and Neck Surgery and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
authors.forename: Dan M
authors.initials: DM
authors.lastname: Fliss
authors.affiliation: Department of Otolaryngology Head and Neck Surgery and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
authors.forename: Moshe
authors.initials: M
authors.lastname: Yehuda
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044963:Biopsy, Fine-Needle; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012017:Referral and Consultation; D012189:Retrospective Studies; D013964:Thyroid Neoplasms / Q000175:diagnosis*; D016606:Thyroid Nodule / Q000175:diagnosis* / Q000473:pathology; D055815:Young Adult
keywords: clinical presentation; fine-needle aspiration (FNA); incidentaloma; thyroid cancer; ultrasound