At our Canadian center, over 700 thyroid FNABs are carried out and evaluated annually. Fortunately, most of the diagnoses are benign, which is consistent with reports from other institutions [4, 9]. Since the implementation and routine utilization of the BSRTC at our center in 2010, a subset of the total FNABs (13.6%) has been diagnosed as being indeterminate (AUS/FLUS or sFN or sM). Of these cases, our overall AUS/FLUS utilization rate was 8.3%, which is marginally higher than the recommended 7% utilization for this BSRTC diagnostic category . An especially challenging diagnosis, AUS/FLUS has a wide range of variability in utilization across institutions, and it has been suggested that the ROM associated with this diagnostic category is actually higher than the quoted 5-15%, being more in the 20-25% range [3-4, 7]. A meta-analysis reported by our group found that for 291 patients with thyroid lesions that underwent operation, the overall ROM for an AUS/FLUS diagnosis was 26.8% .