Long-Term Impact of Thyroid Biopsy Specialists on Efficiency and Quality of Thyroid Biopsy

Objective: To assess consistency and long-term progress in thyroid biopsy performed by trained sonographers under supervision of a radiologist. Methods: Trained sonographers started performing thyroid biopsy at our institute in August 2011. The data for this study were extracted from a prospectively maintained database for ultrasound guided thyroid biopsy and included the number of thyroid fine needle aspiration biopsy procedures performed between August 2011 and 2016 and the final cytopathology report as per the Bethesda Classification. For the analysis, the study was divided into two time periods: initial postimplementation period (August 2011 to 2013) and late postimplementation period (2014-2016). Results: In all, 5,538 thyroid biopsies were performed by trained sonographers in the period, 2,561 in the initial implementation period and 2,977 between 2014 and 2016. The unsatisfactory rates dropped from 21% to 10% in the two periods (P < .001), and the proportion of malignant nodules on cytopathology increased from 6% to 7% in the two periods (P 1/4 .010). Wait times for thyroid biopsies remained low during the period. Conclusion: Sonographers trained to perform ultrasound guided thyroid biopsies provide persistent improved patient care over a longterm period. This reinforces the role of physician extenders in targeted scopes of practice.