The Impact of Intranodular Needle Movements on Cytopathological Outcomes in Fine‐Needle Aspiration Biopsy of Thyroid Nodules

PURPOSE: This study aims to evaluate the effect of the number of needle movements within a thyroid nodule during fine-needle aspiration biopsy (FNAB) on cytopathological outcomes and the need for repeat biopsy. METHODS: A total of 115 nodules in 101 patients (86 females and 15 males; mean age of 52.39 ± 11.9 years) were included. Biopsies were performed without applying negative pressure; instead, a series of forward and backward needle movements were used to sample different areas within the nodule. The number of these movements was recorded. Patients were divided into two groups: Group 1 (≤ 10 intranodular movements) and Group 2 (> 10 intranodular movements). Cytopathological outcomes were compared between groups. RESULTS: The mean diameter of the biopsied nodules was 19.68 ± 9.64 mm (range 5-62 mm). Group 1 included 68 nodules (59.1%), while Group 2 included 47 nodules (40.9%). The rate of atypia of undetermined significance (AUS) was significantly lower in group 1 (p = 0.041). Additionally, the need for repeat biopsy was significantly lower in group 1 (p = 0.010). CONCLUSION: Excessive intranodular needle movements during FNAB of thyroid nodules were associated with higher rates of AUS and increased likelihood of repeat biopsy. The number of intranodular needle movements may be a critical factor influencing FNAB outcomes.