Castellana M, Virili C, Paone G, et al. - In the present study, the researchers sought to examine how risk stratification systems (RSSs) classify autonomously functioning thyroid nodules (AFTNs) and whether RSSs are capable of avoiding unnecessary fine‐needle aspiration (FNA) biopsies in such cases. AFTN patients who had undergone an assessment of US, scintigraphy and thyroid function from December 2016 to December 2017 were chosen. US images have been retrospectively reviewed and AFTN reclassified according to AACE/ACE/AME, ACR‐TIRADS, ATA, BTA, EU‐TIRADS, K‐TIRADS and TIRADS. Risk class and indication for FNA have been evaluated. Of 85 consecutive cases, a total of 87 AFTNs have been registered. The most common categories were low and intermediate risk when AFTNs were reclassified according to US RSSs. According to findings, ultrasound RSSs causes improper FNA in a large number of AFTN patients.