title: Surgeon performed ultrasound-guided fine-needle aspirates of the thyroid: 1067 biopsies and learning curve in a teaching center.
abstract: Surgeon performed ultrasound-guided fine-needle aspirates (UG-FNAs) reduce delay in diagnosis and allow for surgeon surveillance. We present the first report on a learning curve and impact of head and neck surgical trainees on adequacy rates.
  
  
  
  Thyroid UG-FNA biopsies from 2009 to 2013 were reviewed retrospectively. Specimen adequacy, cytologic diagnosis, and surgical pathology were used to calculate adequacy and accuracy.
  
  
  
  One thousand sixty-seven biopsies were examined in 723 individuals. The adequacy rate from adoption into practice improved from 71% to 78% to 85% over 300 cases. When UG-FNA was subsequently taught to trainees, adequacy rates varied among trainees (p < .037), and there were higher nondiagnostic rates earlier in training (p = .04). Adequacy was not related to size or palpability, but cystic lesions yielded more inadequate specimens (p < .001).
  
  
  
  Surgeon performed UG-FNA biopsy can be performed adequately in an outpatient setting. Adequacy rates reach acceptable levels after 300 cases, whereas trainee involvement impacts adequacy rates. © 2015 Wiley Periodicals, Inc. Head Neck 38: E1281-E1284, 2016.
authors: Department of Otolaryngology - Head and Neck Surgery, University of Toronto, Toronto, Ontario, Canada.
authors: Vinay T
authors: VT
authors: Fernandes
authors: Peter MacCallum Cancer Centre, Melbourne, Australia.
authors: Matthew J R
authors: MJ
authors: Magarey
authors: Hofstra North Shore - LIJ School of Medicine, Long Island Jewish Medical Center, New Hyde Park, New York.
authors: Dev P
authors: DP
authors: Kamdar
authors: Department of Otolaryngology - Head and Neck Surgery, University of Toronto, Toronto, Ontario, Canada.|Mount Sinai Hospital, Toronto, Canada.
authors: Jeremy L
authors: JL
authors: Freeman
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044963:Biopsy, Fine-Needle / Q000379:methods*; D002983:Clinical Competence; D005260:Female; D006801:Humans; D059032:Learning Curve; D008297:Male; D008875:Middle Aged; D066231:Surgeons / Q000193:education*; D013961:Thyroid Gland / Q000473:pathology*; D016606:Thyroid Nodule / Q000175:diagnosis* / Q000473:pathology; D014463:Ultrasonography; D055815:Young Adult
keywords: fine-needle aspiration biopsy (FNAB); learning curve; surgeon; thyroid; ultrasound