Fine needle aspiration (FNA) to facilitate this distinction first became widely practiced in the early 1980s (6), and is widely recognized as the gold standard initial diagnostic procedure in the differential diagnosis of thyroid nodules, being accurate, safe, and cost effective (7, 8). The sensitivity (Se), specificity (Sp), positive predictive value (PPV), negative predictive value (NPV), false-negative (FN) rate, and false-positive (FP) ranges of an FNA are 88.2–97.0%, 47.0–98.2%, 52.0–98.0%, 89.0–96.3%, 0.5–10.0%, and 1.0–7.0%, respectively (9).