%0 Journal Article
%T The Role of a Pre-Fine Needle Aspiration Clinic in Improving the Quality of Thyroid Nodule Investigation in Saskatchewan
%A Paige Baldwin
%A Terra Arnason
%A Niomi Singh
%A Robert Otani
%A Gary Groot
%J Open Journal of Radiology
%P 23-34
%@ 2164-3032
%D 2020
%I Scientific Research Publishing
%R 10.4236/ojrad.2020.101004
%X <strong>Background:</strong> The Canadian province of Saskatchewan introduced a pre-fine needle aspiration (FNA) clinic to review adherence of referrals for thyroid biopsy based on the guidelines of the American College of Radiology¡¯s (ACR) Thyroid Imaging, Reporting and Data System (TI-RADS) scoring system. The intention is to minimize low-yield biopsy rates by improving the quality of thyroid nodule investigation in Saskatchewan through this clinic. TI-RADS is a malignancy risk scoring system for thyroid nodules based on five sonographic characteristics: composition, echogenicity, shape, margin, and echogenic foci (calcium). Recommendations for intervention or clinical follow-up are further determined by the size of the nodule. <strong>Methods:</strong> Through a retrospective chart review of all thyroid biopsy referrals to the Royal University Hospital (RUH) in Saskatchewan between 22 March 2016 and 17 May 2018, the impact of the multidisciplinary pre-FNA clinic on appropriate thyroid biopsies in Saskatchewan was evaluated. <strong>Results: </strong>This study evaluated 252 referrals, 203 of which underwent FNA and 23 which received surgical biopsy. TI-RADS scores appended to thyroid biopsy referrals increased upon pre-FNA clinic initiation, yet score quality did not improve. Rates of malignant biopsies were lower than ACR-reporting suggesting inappropriate biopsy of low risk nodules perhaps by overcalling the TI-RADS score. The majority of FNA cytology matched final surgical pathology, with 78% of indeterminate FNAs being malignant, and all non-diagnostic FNAs being benign. <strong>Conclusions: </strong>The implementation of the pre-FNA clinic reduced the number of thyroid biopsies in Saskatchewan by 11% overall.
%K Thyroid Nodules
%K Thyroid Cancer
%K Fine Needle Aspiration Biopsy
%K Thyroid Imaging Reporting and Data System (TIRADS)
%U http://www.scirp.org/journal/PaperInformation.aspx?PaperID=98630