A randomized controlled trial comparing non-selective versus selective TIRADS-based cytology in thyroid cancer diagnostics.
Risk-stratified thyroid biopsy selection improves detection of significant disease, though refinement is still needed before safely reducing unnecessary biopsies.
This first RCT of EU-TIRADS for thyroid nodule FNA selection demonstrates that risk-stratified biopsy improves diagnostic yield of clinically significant cytology without increasing missed cancer rates. However, the safety margin for FNA omission using EU-TIRADS appears narrower than retrospective evidence suggested, indicating further refinement of thyroid ultrasound risk stratification systems is needed before widespread FNA reduction protocols can be recommended.
What the study was
- Study design
- Multi-centre, unblinded, interventional randomized controlled trial
- Population
- Patients with thyroid nodules at 4 hospitals in Western Sweden (Feb 2022 – Dec 2023)
- Sample size
- 195
- Category
- Diagnostics
- Maturity
- Validated
- Journal
- British Journal of Surgery
Why it surfaced
First RCT of EU-TIRADS for thyroid FNA selection; published in Br J Surg. Directly clinically actionable for endocrinology/head and neck surgery practice, though sample size (n=195) limits power for definitive conclusions.
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