Outcomes of the Bethesda system for reporting thyroid cytopathology: Real‐life experience

Avior, Galit; Dagan, Or; Shochat, Ilia; Frenkel, Yulia; Tessler, Idit; Meir, Alona; Jaffe, Anat; Cohen, Oded

doi:10.1111/cen.14341

Cited by 8 publications

(5 citation statements)

References 34 publications

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“…The diagnostic sensitivity, accuracy, and AUC of the combined diagnosis were much higher than those of TIRADS or BRAF V600E separately, in accordance with Wu’s finding 6 , improving the ability to diagnose malignant nodules and reduce false negatives. The malignant rate of thyroid nodules with BRAF V600E mutation and TIRADS classification 4b-5 was up to 89.4% (93/104) in our study, similar to the malignant rate of Bethesda category VI thyroid nodules 35 . Accordingly, TIRADS combined with BRAF V600E mutation analysis reached a valuable diagnostic efficacy for Bethesda III–V thyroid nodules.…”

Section: Discussionsupporting

confidence: 87%

Diagnostic value of thyroid imaging reporting and data system combined with BRAFV600E mutation analysis in Bethesda categories III–V thyroid nodules

Hua

Chen

et al. 2022

Sci Rep

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Fine needle aspiration biopsy is a crucial method for preoperative diagnosis of thyroid nodules. However, thyroid nodules classified as Bethesda categories III–V cannot obtain definite cytological results. Our aim was to study the diagnostic value of thyroid imaging reporting and data system combined with BRAFV600E mutation analysis in Bethesda categories III–V thyroid nodules, so as to provide more precise direction for the follow-up treatments. A total of 174 Bethesda categories III–V thyroid nodules performed TIRADS and BRAFV600E mutation analysis were included in the study. We retrospectively analyzed the ultrasound features as well as the results of BRAFV600E mutation of the 174 thyroid nodules. In the multiple regression analysis models, ultrasound features including lobulated or irregular margin, punctate echogenic foci, and shape with taller-than-wide were statistically significant in malignant nodules (p < 0.05). The area under the curve of the combination of TIRADS and BRAFV600E increased to 0.925, which were much higher than TIRADS (0.861) and BRAFV600E (0.804) separately. Combined diagnosis was of the greatest value to identify Bethesda III–V thyroid nodules definitely, especially with higher sensitivity (93%) and accuracy (90%).

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Section: Discussionsupporting

confidence: 87%

Diagnostic value of thyroid imaging reporting and data system combined with BRAFV600E mutation analysis in Bethesda categories III–V thyroid nodules

Hua

Chen

et al. 2022

Sci Rep

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“…The distribution of the BSRTC categories and the corresponding malignancy rates were in accordance with those reported in previous studies [4,6,7,[11][12][13][14]. The overall malignancy rate was 11.5% but increased to 29.4% when only surgically resected nodules were considered.…”

Section: Danish Medical Journal Danish Medical Journalsupporting

confidence: 88%

Validation of the Bethesda System for Reporting Thyroid Cytopathology in a Danish tertiary centre

Madsen,

Jespersen,

Bonnema

et al. 2024

Dan Med J

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INTRODUCTION. The Bethesda System for Reporting Thyroid Cytopathology (BSRTC) is used to categorise thyroid fine-needle aspiration (FNA). The aim of this study was to validate the BSRTC in a consecutive cohort and to evaluate the derived management in terms of performing repeat FNA or thyroid surgery. METHODS. Results of thyroid FNAs assessed at the Department of Pathology, Aarhus University Hospital, in the period 2016-2019 were retrieved from The Danish Pathology Registry. FNA category according to the BSRTC along with the histological diagnosis (if available) were linked to the individual patient. RESULTS. In total, 3,669 biopsies were included from 2,873 thyroid nodules in 2,547 patients. Repeat FNA was performed in 23.6% of nodules. The majority of primary FNAs were Benign (BSRTC II; 52.4%). Non-diagnostic (ND) (BSRTC I) was found in 26.3% and BSRTC III-VI were found in 3.6-7.5%. Compared with the first with the last FNA, the frequency of Benign (BSRTC II) increased (61.3%), whereas the frequency of ND (BSRTC I) decreased (14.8%). Surgery was performed in 38.2% (n = 1,097) of nodules. The malignancy rate of 11.5% correlated positively with the BSRTC category, being 2.8% in Benign (BSRTC II) and 95.7% in Malignant (BSRTC VI). CONCLUSIONS. The malignancy rates in the BSRTC categories were in accordance with reports from other countries. Since the BSRTC ensures a standardised and concise communication of cytopathology assessments, application of the BSRTC for thyroid nodule management in a Danish setting is recommended. FUNDING. None. TRIAL REGISTRATION. Not relevant.

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“…FNAB had a high false-negative rate in patients with thyroid nodules larger than 4 cm. These nodules exhibit the same follicular growth patterns found in follicular thyroid carcinoma, oncocytic carcinoma, and follicular variants of PTCs ( 31 ).…”

Section: Discussionmentioning

confidence: 64%

Do large thyroid nodules (≥4 cm) without suspicious cytology need surgery?

Kang,

Kim,

Lee

et al. 2023

Front. Endocrinol.

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BackgroundFine-needle aspiration biopsy (FNAB) is a good diagnostic tool for thyroid nodules; however, its high false-negative rate for giant nodules remains controversial. Many clinicians recommend surgical resection for nodules >4 cm owing to an increased risk of malignancy and an increased false-negative rate. This study aimed to examine the feasibility of this approach and investigate the incidence of malignancy in thyroid nodules >4 cm without suspicious cytology based on medical records in our center.MethodsThis was a retrospective analysis of 453 patients that underwent preoperative FNAB for nodules measuring >4 cm between January 2017 and August 2022 at Severance Hospital, Seoul.ResultsAmong the 453 patients, 140 nodules were benign and 119 were indeterminate. Among 259 patients, the final pathology results were divided into benign (149) and cancerous (110) groups, and the prevalence of malignancy was 38.9% in the benign group and 55.5% in the indeterminate group. Among the malignancies, follicular carcinoma and follicular variants of papillary carcinoma were observed in 83% of the cytologically benign group and 62.8% of the indeterminate group.ConclusionPreoperative FNAB had high false-negative rates and low diagnostic accuracy in patients with thyroid nodules >4 cm without suspicious cytologic features; therefore, diagnostic surgery may be considered a treatment option.

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Outcomes of the Bethesda system for reporting thyroid cytopathology: Real‐life experience

Cited by 8 publications

References 34 publications

Diagnostic value of thyroid imaging reporting and data system combined with BRAFV600E mutation analysis in Bethesda categories III–V thyroid nodules

Diagnostic value of thyroid imaging reporting and data system combined with BRAFV600E mutation analysis in Bethesda categories III–V thyroid nodules

Validation of the Bethesda System for Reporting Thyroid Cytopathology in a Danish tertiary centre

Do large thyroid nodules (≥4 cm) without suspicious cytology need surgery?

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