Intraoperative frozen section on indeterminate thyroid nodules

Why not just do an intraoperative frozen section on indeterminate thyroid nodules to help guide the extent of surgery?

Unfortunately, the accuracy of frozen section for most thyroid nodules is not much better than FNA and is, therefore, not routinely used. To distinguish a benign from malignant follicular thyroid lesion requires a detailed assessment for capsular and/or vascular invasion, which cannot practically be accomplished intraoperatively. Frozen section can sometimes be useful for definitive diagnosis of cancer in nodules that are in the suspicious category (Bethesda V).

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