{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T15:23:28Z","timestamp":1788276208558,"version":"build-2803163510"},"reference-count":18,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T00:00:00Z","timestamp":1781568000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T00:00:00Z","timestamp":1781568000000},"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":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Thyroid fine\u2010needle aspiration (FNA) is the primary diagnostic method for evaluating thyroid nodules; however, nondiagnostic results remain a significant limitation, often leading to repeat procedures and delayed diagnosis. Operator specialization and rapid on\u2010site evaluation (ROSE) have been proposed as strategies to improve specimen adequacy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective comparative study included all thyroid FNA procedures performed in 2025 at the University Clinical Center of Kosovo (UCCK), where procedures were performed by endocrinologists and radiologists without routine rapid on\u2010site evaluation (ROSE), and at the Hospital for Tumors, UHC \u201cSisters of Charity\u201d, Zagreb, where procedures were performed by interventional cytopathologists with routine ROSE implementation. Cytology results were classified according to The Bethesda System for Reporting Thyroid Cytopathology. The proportion of nondiagnostic results between institutions was compared using the chi\u2010square test.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 2171 thyroid FNA procedures were analyzed (1728 at UCCK and 443 at Hospital for Tumors). The nondiagnostic rate was significantly higher at UCCK (182\/1728; 10.5%) compared with Hospital for Tumors (11\/443; 2.5%) (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0001), corresponding to an odds ratio of 4.62 (95% CI, 2.50\u20138.54). Repeat FNA was performed in 36.3% of nondiagnostic cases at UCCK, of which 81.8% yielded a diagnostic Bethesda category.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>A significantly lower rate of nondiagnostic thyroid FNA results was observed in the center with interventional cytologists and routine ROSE implementation. These findings support the role of operator specialization and on\u2010site adequacy assessment in improving specimen adequacy and reducing the need for repeat procedures.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/dc.70161","type":"journal-article","created":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T07:18:01Z","timestamp":1781594281000},"page":"719-723","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of Operator Specialization and On\u2010Site Evaluation on Nondiagnostic Thyroid Fine\u2010Needle Aspiration: A Comparative Study"],"prefix":"10.1002","volume":"54","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-4328-9962","authenticated-orcid":false,"given":"Fatlinda","family":"Sadiku","sequence":"first","affiliation":[{"name":"Department of Histology and Embryology, Faculty of Medicine University of Prishtina  Prishtina Kosovo"},{"name":"Institute of Pathology University Clinical Center of Kosovo  Prishtina Kosovo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marija","family":"\u0160kerlj","sequence":"additional","affiliation":[{"name":"Department of Clinical Cytology, Hospital for Tumors University Hospital Center \u201cSisters of Charity\u201d  Zagreb Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vesna","family":"Ramljak","sequence":"additional","affiliation":[{"name":"Department of Clinical Cytology, Hospital for Tumors University Hospital Center \u201cSisters of Charity\u201d  Zagreb Croatia"},{"name":"Department of Pathology, School of Medicine University of Zagreb  Zagreb Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,16]]},"reference":[{"issue":"4","key":"e_1_2_12_2_1","first-page":"197","article-title":"The 2023 Bethesda System for Reporting Thyroid Cytopathology","volume":"12","author":"Ali S. Z.","year":"2023","journal-title":"Journal of the American Society of Cytopathology"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2265.2011.04011.x"},{"issue":"11","key":"e_1_2_12_4_1","first-page":"954","article-title":"Ultrasound\u2010Guided Fine Needle Aspiration Cytology in the Diagnosis and Management of Thyroid Nodules","volume":"120","author":"Cai X. J.","year":"2006","journal-title":"Journal of Laryngology and Otology"},{"key":"e_1_2_12_5_1","first-page":"10","article-title":"Can We Improve Thyroid Fine\u2010Needle Aspiration Cytology Adequacy in a Low\u2010Volume Thyroid Center?","volume":"15","author":"Shaaban M.","year":"2018","journal-title":"CytoJournal"},{"issue":"5","key":"e_1_2_12_6_1","first-page":"357","article-title":"The Impact of Rapid On\u2010Site Evaluation on Thyroid Fine\u2010Needle Aspiration Biopsy","volume":"128","author":"Pastorello R. G.","year":"2020","journal-title":"Cancer Cytopathology"},{"issue":"6","key":"e_1_2_12_7_1","first-page":"354","article-title":"The Value of Onsite Adequacy Assessment of Thyroid Fine\u2010Needle Aspirations Is a Function of Operator Experience","volume":"96","author":"Ghofrani M.","year":"2002","journal-title":"Cancer"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.4103\/cytojournal.cytojournal_32_17"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1159\/000339959"},{"issue":"5","key":"e_1_2_12_10_1","first-page":"429","article-title":"Non\u2010Diagnostic Rates for Thyroid Fine Needle Aspiration Are Negatively Correlated With Positive for Malignancy Rates","volume":"55","author":"Renshaw A. A.","year":"2011","journal-title":"Acta Cytologica"},{"issue":"6","key":"e_1_2_12_11_1","first-page":"517","article-title":"Malignancy Rates in Different Diagnostic Categories of the Bethesda System","volume":"38","author":"Arul P.","year":"2015","journal-title":"Biomed"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2015.0020"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11547-010-0528-x"},{"issue":"5","key":"e_1_2_12_14_1","first-page":"777","article-title":"Fine\u2010Needle Aspiration Biopsy: Experienced Versus Inexperienced Physicians","volume":"16","author":"Gursoy A.","year":"2010","journal-title":"Endocrine Practice"},{"issue":"9","key":"e_1_2_12_15_1","first-page":"1731","article-title":"Rapid On\u2010Site Evaluation (ROSE) for Fine Needle Aspiration of Thyroid: Benefits, Challenges and Innovative Solutions","volume":"46","author":"Michael C. W.","year":"2023","journal-title":"Journal of Endocrinological Investigation"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2012.0211"},{"issue":"5","key":"e_1_2_12_17_1","first-page":"322","article-title":"Rapid On\u2010Site Evaluation by Cytology Scientists","volume":"25","author":"Stewart J.","year":"2014","journal-title":"Cytopathology"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2010.0243"},{"key":"e_1_2_12_19_1","first-page":"35","article-title":"Factors Affecting Thyroid Nodule Fine Needle Aspiration Non\u2010Diagnostic Rates","volume":"43","author":"Houdek D.","year":"2014","journal-title":"Journal of Otolaryngology\u2014Head & Neck Surgery"}],"container-title":["Diagnostic Cytopathology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/dc.70161","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/dc.70161","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/dc.70161","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T15:00:04Z","timestamp":1788274804000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/dc.70161"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,16]]},"references-count":18,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2026,10]]}},"alternative-id":["10.1002\/dc.70161"],"URL":"https:\/\/doi.org\/10.1002\/dc.70161","archive":["Portico"],"relation":{},"ISSN":["8755-1039","1097-0339"],"issn-type":[{"value":"8755-1039","type":"print"},{"value":"1097-0339","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,16]]},"assertion":[{"value":"2026-04-08","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-07","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-16","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}