Thyroid fine needle aspiration: is cytopathologist review of ultrasound features useful?

Cytopathologist review of thyroid US has been proposed to be useful in diagnosis and patient triage. This editorial explores the implications for practicing cytopathologists of integrating US review into thyroid FNA diagnosis. At present there is no agreed upon system for combining cytologic and ultrasound (US) features and communicating those results as a single report. If cytologists are performing tasks that require expertise in US interpretation, then they should know and be fully conversant with US interpretation. Whether cytologists performing aspirations require expertise in US interpretation is not clear. Regardless, cytologists should avoid using US results to alter their cytologic interpretations unless they clearly communicate that this is what they are doing. An evidence-based integrated reporting system that would allow cytologists to clearly explain to other physicians exactly how they reached their interpretation might provide value beyond current standard practice.