Assessment of the Bethesda System for Reporting Thyroid Cytopathology

Jennifer L. Sauter, Heidi Lehrke, Xiaotun Zhang, Osamah T. Al Badri, Rene Rodriguez-Gutierrez, Danae A. Delivanis, Naykky Singh Ospina, Diane Donegan, Oksana Hamidi, Nicole Iñiguez-Ariza, Anu Sharma, Nana Esi N. Kittah, Shrikant U. Tamhane, Maria D. Hurtado Andrade, Anupam Kotwal, Sarah M. Jenkins, Grant Spears, Michael Rivera, Diana S. Dean, Michael R. Henry

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Objectives: Long-term follow-up is important for determining performance characteristics of thyroid fine-needle aspiration (FNA). Methods: Histologic or 3 or more years of clinical follow-up was used to calculate performance characteristics of thyroid FNA before and after implementation of The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC). The impact of noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) classification was also investigated. Results: Follow-up was obtained for 1,277/1,134 and 1,616/1,393 aspirates/patients (median clinical follow-up, 9.9 and 4.4 years, pre- and post-TBSRTC, respectively). Nondiagnostic, suspicious for follicular neoplasm, and suspicious for malignancy (SFM) diagnoses decreased and benign diagnoses increased post-TBSRTC, while atypical rate remained less than 1%. Negative predictive value for benign nodules and positive predictive value (PPV) for SFM increased significantly. Eleven nodules were reclassified as NIFTP, slightly decreasing PPV/risk of malignancy (ROM). Conclusions: Appropriate ROM for thyroid FNA can be achieved through application of TBSRTC terminology with minimal use of atypical category.

Original languageEnglish (US)
Pages (from-to)502-511
Number of pages10
JournalAmerican journal of clinical pathology
Volume152
Issue number4
DOIs
StatePublished - Sep 9 2019

Fingerprint

Thyroid Gland
Fine Needle Biopsy
Neoplasms
Thyroid Neoplasms
Terminology

Keywords

  • Atypia of undetermined significance/follicular lesion of undetermined significance
  • Bethesda
  • Cytopathology
  • Fine-needle aspiration
  • FNA
  • Follicular neoplasm/suspicious for follicular neoplasm
  • Noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP)
  • Papillary thyroid carcinoma
  • Risk of malignancy
  • Thyroid

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

Cite this

Sauter, J. L., Lehrke, H., Zhang, X., Al Badri, O. T., Rodriguez-Gutierrez, R., Delivanis, D. A., ... Henry, M. R. (2019). Assessment of the Bethesda System for Reporting Thyroid Cytopathology. American journal of clinical pathology, 152(4), 502-511. https://doi.org/10.1093/ajcp/aqz076

Assessment of the Bethesda System for Reporting Thyroid Cytopathology. / Sauter, Jennifer L.; Lehrke, Heidi; Zhang, Xiaotun; Al Badri, Osamah T.; Rodriguez-Gutierrez, Rene; Delivanis, Danae A.; Singh Ospina, Naykky; Donegan, Diane; Hamidi, Oksana; Iñiguez-Ariza, Nicole; Sharma, Anu; Kittah, Nana Esi N.; Tamhane, Shrikant U.; Hurtado Andrade, Maria D.; Kotwal, Anupam; Jenkins, Sarah M.; Spears, Grant; Rivera, Michael; Dean, Diana S.; Henry, Michael R.

In: American journal of clinical pathology, Vol. 152, No. 4, 09.09.2019, p. 502-511.

Research output: Contribution to journalArticle

Sauter, JL, Lehrke, H, Zhang, X, Al Badri, OT, Rodriguez-Gutierrez, R, Delivanis, DA, Singh Ospina, N, Donegan, D, Hamidi, O, Iñiguez-Ariza, N, Sharma, A, Kittah, NEN, Tamhane, SU, Hurtado Andrade, MD, Kotwal, A, Jenkins, SM, Spears, G, Rivera, M, Dean, DS & Henry, MR 2019, 'Assessment of the Bethesda System for Reporting Thyroid Cytopathology', American journal of clinical pathology, vol. 152, no. 4, pp. 502-511. https://doi.org/10.1093/ajcp/aqz076
Sauter JL, Lehrke H, Zhang X, Al Badri OT, Rodriguez-Gutierrez R, Delivanis DA et al. Assessment of the Bethesda System for Reporting Thyroid Cytopathology. American journal of clinical pathology. 2019 Sep 9;152(4):502-511. https://doi.org/10.1093/ajcp/aqz076
Sauter, Jennifer L. ; Lehrke, Heidi ; Zhang, Xiaotun ; Al Badri, Osamah T. ; Rodriguez-Gutierrez, Rene ; Delivanis, Danae A. ; Singh Ospina, Naykky ; Donegan, Diane ; Hamidi, Oksana ; Iñiguez-Ariza, Nicole ; Sharma, Anu ; Kittah, Nana Esi N. ; Tamhane, Shrikant U. ; Hurtado Andrade, Maria D. ; Kotwal, Anupam ; Jenkins, Sarah M. ; Spears, Grant ; Rivera, Michael ; Dean, Diana S. ; Henry, Michael R. / Assessment of the Bethesda System for Reporting Thyroid Cytopathology. In: American journal of clinical pathology. 2019 ; Vol. 152, No. 4. pp. 502-511.
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AU - Sauter, Jennifer L.

AU - Lehrke, Heidi

AU - Zhang, Xiaotun

AU - Al Badri, Osamah T.

AU - Rodriguez-Gutierrez, Rene

AU - Delivanis, Danae A.

AU - Singh Ospina, Naykky

AU - Donegan, Diane

AU - Hamidi, Oksana

AU - Iñiguez-Ariza, Nicole

AU - Sharma, Anu

AU - Kittah, Nana Esi N.

AU - Tamhane, Shrikant U.

AU - Hurtado Andrade, Maria D.

AU - Kotwal, Anupam

AU - Jenkins, Sarah M.

AU - Spears, Grant

AU - Rivera, Michael

AU - Dean, Diana S.

AU - Henry, Michael R.

PY - 2019/9/9

Y1 - 2019/9/9

N2 - Objectives: Long-term follow-up is important for determining performance characteristics of thyroid fine-needle aspiration (FNA). Methods: Histologic or 3 or more years of clinical follow-up was used to calculate performance characteristics of thyroid FNA before and after implementation of The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC). The impact of noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) classification was also investigated. Results: Follow-up was obtained for 1,277/1,134 and 1,616/1,393 aspirates/patients (median clinical follow-up, 9.9 and 4.4 years, pre- and post-TBSRTC, respectively). Nondiagnostic, suspicious for follicular neoplasm, and suspicious for malignancy (SFM) diagnoses decreased and benign diagnoses increased post-TBSRTC, while atypical rate remained less than 1%. Negative predictive value for benign nodules and positive predictive value (PPV) for SFM increased significantly. Eleven nodules were reclassified as NIFTP, slightly decreasing PPV/risk of malignancy (ROM). Conclusions: Appropriate ROM for thyroid FNA can be achieved through application of TBSRTC terminology with minimal use of atypical category.

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KW - Follicular neoplasm/suspicious for follicular neoplasm

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KW - Papillary thyroid carcinoma

KW - Risk of malignancy

KW - Thyroid

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