TITLE:
Nondiagnostic Cytology and Recorded Subsequent Care after Ultrasound-Guided Thyroid Fine-Needle Aspiration
AUTHORS:
Aditya Pandya, Asch Murray
KEYWORDS:
Thyroid Nodule, Fine-Needle Aspiration, Nondiagnostic Cytology, Quality Assurance, ACR TI-RADS
JOURNAL NAME:
Open Journal of Radiology,
Vol.16 No.4,
November
4,
2026
ABSTRACT: Background: Nondiagnostic thyroid fine-needle aspiration (FNA) can prompt further assessment, but a repeat-biopsy plan does not establish diagnostic resolution. We described index cytology and recorded subsequent care in a community-hospital sample. Methods: This retrospective quality-assurance study included 96 patients with index FNA during January 2022-October 2025. Case identification combined randomly generated dates with first-listed eligible patient selection. The index procedure was the first FNA within the study period; the largest biopsied nodule was analyzed. The routine protocol used a 25-gauge needle and three passes without rapid on-site evaluation. Records were reviewed through December 2025. The primary outcome was the nondiagnostic proportion in the reviewed sample. Results: Index cytology was nondiagnostic in 26/96 index nodules (27.1%). Among the 26 patients with nondiagnostic index-nodule cytology, 17 had repeat biopsy listed as management and 12 had available same-nodule repeat cytology: seven benign and five nondiagnostic results. Six patients had no further FNA recorded. Thyroid surgery was recorded in 10/96 patients. Twelve biopsied nodules fell outside routine American College of Radiology Thyroid Imaging Reporting and Data System category-and-size criteria; three yielded malignant cytology. Eighty-four index procedures (87.5%) occurred in 2022. Conclusion: Nondiagnostic cytology was frequent in this selected sample, supporting review of sampling, specimen processing, and documentation of subsequent assessment. First-listed patient selection, the predominance of 2022 index procedures, and incomplete follow-up limit inference about service-wide performance and complete diagnostic resolution.