{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T08:45:32Z","timestamp":1792053932455,"version":"4.4.0"},"reference-count":45,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,12,23]],"date-time":"2025-12-23T00:00:00Z","timestamp":1766448000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,12,23]],"date-time":"2025-12-23T00:00:00Z","timestamp":1766448000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["acsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Cytopathology"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Ultrasound\u2010guided fine\u2010needle aspiration (FNA) of various thyroid nodules often yields nondiagnostic results, which reveal a wide range of the risk of malignancy (ROM) and complicate patient management decisions. This ROM variability likely reflects selection bias, given that previous studies frequently excluded patients without histologic follow\u2010up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective cohort study included 1269 patients with nondiagnostic thyroid nodules from a total of 10,337 patients who underwent FNA at Asan Medical Center. The ROM was determined on the basis of pathologic findings after core needle biopsy (CNB) or resection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The median follow\u2010up period after the initial FNA was 14.14 months (range, 0.03\u2013145.81 months). Histologic follow\u2010up was available for 361 patients (28.4%), with 49 patients (13.6%) having only surgical resection specimens, 252 patients (69.8%) having only CNB specimens, and 60 patients (16.6%) having both resection and CNB specimens. Sixty\u2010four patients were diagnosed with malignancy on the basis of CNB or surgical resection. The ROM in this cohort ranged from 5.0% to 17.7%. The upper limit of the ROM (13.2%) at the 12\u2010month follow\u2010up in this study was the same as the mean ROM (13%) suggested in The Bethesda System for Reporting Thyroid Cytopathology as updated in 2023. Multivariate logistic regression revealed that younger age (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a0.013), spiculated margins (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a0.010), and hypoechogenicity (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a0.001) were independently associated with malignancy.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study aimed to reduce the overestimated upper limit of the ROM in nondiagnostic thyroid nodules, which was previously based solely on rare surgical follow\u2010up results. Using CNB as an ancillary diagnostic tool can help to rapidly characterize initially nondiagnostic thyroid nodules and guide appropriate management.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cncy.70068","type":"journal-article","created":{"date-parts":[[2025,12,23]],"date-time":"2025-12-23T11:05:27Z","timestamp":1766487927000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Reevaluation of malignancy risk in nondiagnostic thyroid nodules with long\u2010term follow\u2010up via surgical resection or core needle biopsy: A retrospective study"],"prefix":"10.1002","volume":"134","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4596-3658","authenticated-orcid":false,"given":"Ji\u2010Seon","family":"Jeong","sequence":"first","affiliation":[{"name":"Department of Pathology Asan Medical Center University of Ulsan College of Medicine  Seoul Republic of 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