Investigation of the effect of practitioner experience onpathology results in thyroid fine needle aspirationbiopsys

ABSTRACT Introduction and Objective: Thyroid nodules are round lesions with a structure different from normal thyroid tissue and are among the most common pathological conditions of the thyroid gland. Fine-Needle Aspiration Biopsy (FNAB) is the gold standard method for distinguishing whether thyroid nodules are benign or malignant, with a high diagnostic accuracy rate of 97%. However, the rate of non-diagnostic results can range between 5% and 40%. This study aims to evaluate the impact of practitioner experience on the diagnostic success of FNAB, as well as the influence of nodule characteristics (solid, semisolid, cystic), and patient factors such as age and gender, on the results. Materials and Methods: This retrospective study was conducted at the Interventional Radiology Unit of Dicle University Hospital, evaluating the biopsy adequacy, nodule types, and cytological diagnoses of patients who underwent FNAB. A total of 215 patients who underwent FNAB between June 1, 2023, and October 30, 2023, were included. Of the biopsies, 107 were performed by experienced physicians, and 108 by physicians with less than five years of experience. Statistical analyses were performed using SPSS version 27. Results: Of the patients, 77.2% were female, and the mean age was calculated as 45.06 years. FNAB was performed once in 85.1% of patients and multiple times in 14.9%. The nodules were classified as solid in 50.7%, semisolid in 45.6%, and cystic in 3.7%. In terms of cytological diagnoses, 55.3% of the nodules were benign, 25.6% were non-diagnostic, and 11.2% were malignant. A total of 74.4% of the biopsies were considered adequate. The adequacy rate of biopsies performed by experienced physicians (82.2%) was significantly higher than those performed by less experienced physicians (66.7%) (p=0.009). There was no statistically significant relationship between the practitioner group and patient gender (p=0.154) or age (p=0.745). A significant relationship was found between nodule type and cytological diagnoses (p=0.003); most biopsies from cystic nodules yielded non-diagnostic results. Conclusion: Experienced physicians were found to have higher biopsy adequacy rates in FNAB, indicating that practitioner experience is a critical factor in biopsy quality. Additionally, the adequacy rate of biopsies from cystic nodules was significantly lower, suggesting that cystic components present challenges in cytological diagnosis. Keywords: Thyroid, Nodule, Fine-needle aspiration biopsy, Biopsy adequacy, Practitioner experience