{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T09:10:35Z","timestamp":1789204235624,"version":"build-2803163510"},"reference-count":14,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T00:00:00Z","timestamp":1777939200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T00:00:00Z","timestamp":1777939200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diagnostic Cytopathology"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Fine needle aspiration (FNA) is the primary diagnostic tool for evaluating thyroid nodules. However, 10%\u201321% of FNAs yield non\u2010diagnostic (ND) results (Bethesda category I). Repeated ND findings occur in 25%\u201367.5% of cases, creating diagnostic uncertainty and increased healthcare costs. Our aim was to evaluate whether cumulative analysis of repeated ND cytology samples enables reclassification into a diagnostic Bethesda category.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective observational study (2013\u20132024) included patients with \u2265\u20092 ND FNA results from the same thyroid nodule. Two blinded cytopathologists performed cumulative assessment of cellular material from consecutive ND samples to determine if reclassification into diagnostic Bethesda categories was feasible.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 1861 FNA procedures, 29 patients (1.56%) had \u2265\u20092 ND results. Cumulative assessment enabled reclassification in 3\/29 patients (10.3%), into Bethesda category II (benign).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Findings<\/jats:title>\n                    <jats:p>In selected cases, cumulative cytological assessment of multiple ND FNAs may provide sufficient diagnostic material to allow reclassification. This novel cost\u2010effective approach may help reduce diagnostic uncertainty and unnecessary procedures, and improve patient care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/dc.70139","type":"journal-article","created":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T10:41:16Z","timestamp":1777977676000},"page":"576-581","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Cumulative Cytological Assessment of Repeated Non\u2010Diagnostic Thyroid Fine Needle Aspirations: A Novel Approach to Reduce Diagnostic Uncertainty"],"prefix":"10.1002","volume":"54","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-9307-1824","authenticated-orcid":false,"given":"Shiri","family":"Damti Geva","sequence":"first","affiliation":[{"name":"Azrieli Faculty of Medicine Bar\u2010Ilan University  Safed Israel"},{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Galilee Medical Center  Nahariya Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-0843-4270","authenticated-orcid":false,"given":"Wafaa Emiel","family":"Haj","sequence":"additional","affiliation":[{"name":"Azrieli Faculty of Medicine Bar\u2010Ilan University  Safed Israel"},{"name":"Department of Pathology Galilee Medical Center  Nahariya Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-3581-0229","authenticated-orcid":false,"given":"Yokhanan","family":"Spivak","sequence":"additional","affiliation":[{"name":"Azrieli Faculty of Medicine Bar\u2010Ilan University  Safed Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-3303-2521","authenticated-orcid":false,"given":"Yara","family":"Assaf","sequence":"additional","affiliation":[{"name":"Azrieli Faculty of Medicine Bar\u2010Ilan University  Safed Israel"},{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Galilee Medical Center  Nahariya Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-6131-984X","authenticated-orcid":false,"given":"Mussa","family":"Abed Al Aziz","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Galilee Medical Center  Nahariya Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-1006-6740","authenticated-orcid":false,"given":"Daniella","family":"Itzhak","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Galilee Medical Center  Nahariya Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-2609-7925","authenticated-orcid":false,"given":"Alejandro","family":"Livoff","sequence":"additional","affiliation":[{"name":"Azrieli Faculty of Medicine Bar\u2010Ilan University  Safed Israel"},{"name":"Department of Pathology Galilee Medical Center  Nahariya Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7084-0695","authenticated-orcid":false,"given":"Ohad","family":"Ronen","sequence":"additional","affiliation":[{"name":"Azrieli Faculty of Medicine Bar\u2010Ilan University  Safed Israel"},{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Galilee Medical Center  Nahariya Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,5]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2015.0020"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncy.21612"},{"key":"e_1_2_12_4_1","volume-title":"The Bethesda System for Reporting Thyroid Cytopathology","author":"Cibas E. S.","year":"2023"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/cen.14080"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1159\/000334214"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-200205000-00007"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/dc.20830"},{"issue":"1","key":"e_1_2_12_9_1","doi-asserted-by":"crossref","first-page":"e097","DOI":"10.1055\/s-0041-1730298","article-title":"The Bethesda System for Reporting Thyroid Cytopathology: Validating at Tribhuvan University Teaching Hospital","volume":"26","author":"Acharya K.","year":"2022","journal-title":"International Archives of Otorhinolaryngology"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncy.21858"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40618-020-01254-0"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.20829"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.12659\/MSM.905718"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-018-31955-9"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eprac.2020.09.017"}],"container-title":["Diagnostic Cytopathology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/dc.70139","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/dc.70139","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/dc.70139","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T18:09:57Z","timestamp":1783015797000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/dc.70139"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,5]]},"references-count":14,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2026,8]]}},"alternative-id":["10.1002\/dc.70139"],"URL":"https:\/\/doi.org\/10.1002\/dc.70139","archive":["Portico"],"relation":{},"ISSN":["8755-1039","1097-0339"],"issn-type":[{"value":"8755-1039","type":"print"},{"value":"1097-0339","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,5]]},"assertion":[{"value":"2026-01-30","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-29","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-05","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}