Non-diagnostic thyroid FNAs fell from 34% to under 9% with dedicated, trained biopsy operators

The edition in brief

Today's radiology edition ends on a quality-improvement study with a large effect. At one academic centre, a structured programme of sonographer-performed thyroid fine-needle aspiration under radiologist supervision, across 14,127 nodules between 2008 and 2022, saw non-diagnostic rates fall from 34% before the programme to 8.6% in its later years, while malignant cytology rose; in the same period, other operators had a 29% non-diagnostic rate. European neuroradiologists have published expert recommendations on reducing gadolinium in paediatric neuroimaging, asking for each contrast dose to be justified case by case given evidence of brain retention after repeated use. A secondary analysis of the TENSION trial in 198 patients with large-core stroke found that net water uptake on non-contrast CT predicted 12-month disability, discriminated better than ASPECTS, and modified the effect of thrombectomy. A retrospective spectral CT study of 85 patients found iodine and effective atomic number maps distinguished intrapancreatic accessory spleen from hypervascular pancreatic tumours on a single portal-venous phase, with accuracy rising from 61% to 88% when added to conventional images. The pearl covers what makes a thyroid FNA adequate.