Unanswered Questions

Fine Needle Aspiration in the Investigation of Thyroid Nodules—Indications, Procedures, and Interpretation by PD Dr. med. Joachim Feldkamp, Prof. Dr. Dr. med. Dagmar Führer, Prof. Dr. med. Markus Luster, Prof. Dr. med. Thomas J. Musholt, Prof. Dr. med. Christine Spitzweg, and Prof. Dr. med. Matthias Schott in issue 20/2016

I am a general practitioner who does thyroid ultrasonography himself. My experience with two large nuclear medical practices has been that in nodules of unclear dignity, MIBI scintigraphy is undertaken almost as a matter of routine. If the results of such an investigation do not indicate a malignant nodule, then no further diagnostic evaluation is required. If malignancy is still suspected, then the advice is to have surgery.

Fine needle aspiration biopsy instead of MIBI scintigraphy seems to me to be the exception rather than the rule. In my experience, there are few centers where patients might be referred to for FNA biopsy.

If one were to follow the assessment provided by Feldkamp et al., the diagnostic pathway for the investigation of thyroid nodules would have to be changed (1). However, it should not be forgotten that patients view a second scintigram as much more innocuous than fine needle aspiration. I would therefore invite the authors to comment again on this issue.

DOI: 10.3238/arztebl.2017.0026a

Dr. med. Eberhard Backus

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References

1. Feldkamp J, Führer D, Luster M, Musholt TJ, Spitzweg C, Schott M: Fine needle aspiration in the investigation of thyroid nodules—indications, procedures and interpretation. Dtsch Arztebl Int 2016; 113: 353–9