Thyroid Scanning or Fine-Needle Biopsy

Excerpt

To the editor: The suggestion of Reasner and Isley (1)that fine-needle aspiration biopsy may be more cost effective as the initial diagnostic procedure in the evaluation of a solitary thyroid nodule may not be valid. They cite a study (2) that used a decision-analysis model to ascertain the comparative cost effectiveness of radioisotope scanning and aspiration biopsy for initial screening of solitary nodules. In this study, scans of solitary nodules were assigned to one of two categories, hot (hyperfunctional) or cold (isofunctional or hypofunctional). According to the decision tree, if a scan was obtained first and the nodule was cold,