Discussion
THYROID
To the best of our knowledge, this study was the first to compare the preoperative performance of MD and [A schematic representation of a stepwise approach in nononcocytic nodules that starts with either MD or [Preoperative diagnostic workup with stepwise use of MD and [Based on this study and in line with other literature, MD including CNA analysis could be considered in the preoperative workup of oncocytic ITN, in particular if larger validation studies can confirm these results.Quantitative [An important advantage of MD over [Possible nondiagnostic results because of issues with the quality and quantity of the cytology are considered a downside of MD. Nondiagnostic results occurred in this study (It is currently not fully understood which molecular alterations underlie the higher (false-positive) [In a recent study including a subcohort of the In this study, a wide range of molecular alterations was observed in small numbers and it was not possible to correlate the type of molecular alteration to the [The costs of MD and [The preoperative differentiation of ITN may improve if an ultrasound classification system such as European Thyroid Imaging Reporting and Data System or ATA is applied in addition to [The main limitation of this study is the rate of nondiagnostic MD results on cytology and consequent exclusion of patients for the primary analysis. Fortunately, the excluded patients were likely a random sample, as no significant differences in failed MD were observed in relation to the age of cytology smears (3 to 6 years old, According to the current Dutch thyroid guidelines, routine FNAC is only recommended for palpable nodules, regardless of their ultrasound pattern with the exception of a simple cyst.Besides that, there is the possibility of sampling error and imperfections in the morphological histopathological diagnosis as a reference standard.In conclusion, this study demonstrated that both MD and [