Endocrine Abstracts

Introduction: A weekly endocrinology–radiology multidisciplinary (MDT) meeting has been recently introduced in our hospital to discuss indications and suitability of thyroid nodules for fine-needle aspiration (FNA). In a recent 5 years retrospective audit, 80% of thyroids FNAs were performed under ultrasound (US) guidance in our institution with an overall inadequacy (Thy1) rate of 11.1%.

Objectives: The aim of this study was to assess whether such an intervention can improve percentage of FNAs done under US guidance and reduce inadequacy rates.

Methods: A retrospective review of all computerised meeting records held in 2013. Cytological outcomes for those undergone FNA were obtained from pathology laboratory system.

Results: 216 thyroid cases were discussed at our MDT meetings between January and December 2013, of those, FNA was recommended in 118 (54.6%), follow-up US thyroid in 39 (18%), and further images (mainly isotope uptake) in 28 (13%) cases. FNA was not indicated in 31 (14.3%) of cases most of them were small (<1 cm), stable, or hot nodules. 113 thyroid nodules were aspirated following MDT discussion. All FNAs (100%) were performed under US guidance with pathology in attendance to review adequacy of samples. The cytology outcomes were as follows: Thy1 (non-diagnostic) in six (5.3%) cases, Thy2 (benign) in 97 (85.8%) cases, Thy3 (follicular lesion/neoplasm) in seven (6.2%) cases, Thy4 (suspicious for malignancy) in one (0.9%), and Thy5 (malignant) in two (1.8%) cases. Inadequacy rate for FNAs performed following discussion at MDT was significantly lower (5.3%) compared to the overall inadequacy rate of 11.1% reported in the previous audit period (P<0.05).

Conclusion: The introduction of endocrinology–radiology MDT resulted in a 52.3% reduction of thyroid FNA inadequacy rate. This MDT proved to be a cost effective intervention in reducing inadequacy rate, hence further costs. All thyroid nodules should be discussed at such meeting to assess suitability for FNA.