Reporting thyroid FNA before and after implementation of the Bethesda system-one institution's experience
Background The Bethesda System for Reporting Thyroid Cytopathology was published in 2008 and was implemented at Beth Israel Deaconess Medical Center (BIDMC) in June, 2010. Prior to this date, our diagnostic scheme was similar to the Bethesda System, except for the category of “Atypia/Follicular Lesi...
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| Veröffentlicht in: | Diagnostic cytopathology 2015-01, Vol.43 (1), p.28-31 |
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| creator | Brister, Kathriel J. Singh, Remmi S. Wang, Helen H. |
| description | Background
The Bethesda System for Reporting Thyroid Cytopathology was published in 2008 and was implemented at Beth Israel Deaconess Medical Center (BIDMC) in June, 2010. Prior to this date, our diagnostic scheme was similar to the Bethesda System, except for the category of “Atypia/Follicular Lesion of Undetermined Significance” (AUS). This study evaluates the impact of the Bethesda System on the rate and the positive predictive value (PPV) of the diagnostic categories at BIDMC.
Methods
We performed a retrospective review of all thyroid fine‐needle aspirations (FNAs) during the time periods January, 2006 to November, 2008 and June, 2010 to July, 2011 and the subsequent thyroidectomy specimens.
Results
Post‐Bethesda System, diagnoses that are equivocal for diverse reasons and which have wide‐ranging PPVs are now all grouped into the AUS category, and the proportion of cases that are in the atypical/AUS category rose from 3.7% in the pre‐Bethesda period to 12% in the post‐Bethesda period.
Conclusion
The AUS category has a PPV approaching 50% in our lab. This creates uncertainty regarding the appropriate management for this category and may cause unnecessary overuse of molecular testing for cases in the AUS category. Diagn. Cytopathol. 2015;43:28–31. © 2014 Wiley Periodicals, Inc. |
| doi_str_mv | 10.1002/dc.23182 |
| format | Article |
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The Bethesda System for Reporting Thyroid Cytopathology was published in 2008 and was implemented at Beth Israel Deaconess Medical Center (BIDMC) in June, 2010. Prior to this date, our diagnostic scheme was similar to the Bethesda System, except for the category of “Atypia/Follicular Lesion of Undetermined Significance” (AUS). This study evaluates the impact of the Bethesda System on the rate and the positive predictive value (PPV) of the diagnostic categories at BIDMC.
Methods
We performed a retrospective review of all thyroid fine‐needle aspirations (FNAs) during the time periods January, 2006 to November, 2008 and June, 2010 to July, 2011 and the subsequent thyroidectomy specimens.
Results
Post‐Bethesda System, diagnoses that are equivocal for diverse reasons and which have wide‐ranging PPVs are now all grouped into the AUS category, and the proportion of cases that are in the atypical/AUS category rose from 3.7% in the pre‐Bethesda period to 12% in the post‐Bethesda period.
Conclusion
The AUS category has a PPV approaching 50% in our lab. This creates uncertainty regarding the appropriate management for this category and may cause unnecessary overuse of molecular testing for cases in the AUS category. Diagn. Cytopathol. 2015;43:28–31. © 2014 Wiley Periodicals, Inc.</description><identifier>ISSN: 8755-1039</identifier><identifier>EISSN: 1097-0339</identifier><identifier>DOI: 10.1002/dc.23182</identifier><identifier>PMID: 24863008</identifier><language>eng</language><publisher>United States: Blackwell Publishing Ltd</publisher><subject>Adenoma, Oxyphilic ; atypia ; Bethesda System ; Biopsy, Fine-Needle - methods ; Biopsy, Fine-Needle - standards ; Carcinoma - classification ; Carcinoma - pathology ; Diagnosis, Differential ; FNA ; Humans ; Medical Records ; National Cancer Institute (U.S.) ; Sensitivity and Specificity ; thyroid ; Thyroid Neoplasms - classification ; Thyroid Neoplasms - pathology ; undetermined significance ; United States</subject><ispartof>Diagnostic cytopathology, 2015-01, Vol.43 (1), p.28-31</ispartof><rights>2014 Wiley Periodicals, Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3872-7910edd745b9919032c9509d851e5cdd0ea8b8311c0aabbd0a6a488c701e43a43</citedby><cites>FETCH-LOGICAL-c3872-7910edd745b9919032c9509d851e5cdd0ea8b8311c0aabbd0a6a488c701e43a43</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fdc.23182$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fdc.23182$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,778,782,1414,27911,27912,45561,45562</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24863008$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Brister, Kathriel J.</creatorcontrib><creatorcontrib>Singh, Remmi S.</creatorcontrib><creatorcontrib>Wang, Helen H.</creatorcontrib><title>Reporting thyroid FNA before and after implementation of the Bethesda system-one institution's experience</title><title>Diagnostic cytopathology</title><addtitle>Diagn. Cytopathol</addtitle><description>Background
The Bethesda System for Reporting Thyroid Cytopathology was published in 2008 and was implemented at Beth Israel Deaconess Medical Center (BIDMC) in June, 2010. Prior to this date, our diagnostic scheme was similar to the Bethesda System, except for the category of “Atypia/Follicular Lesion of Undetermined Significance” (AUS). This study evaluates the impact of the Bethesda System on the rate and the positive predictive value (PPV) of the diagnostic categories at BIDMC.
Methods
We performed a retrospective review of all thyroid fine‐needle aspirations (FNAs) during the time periods January, 2006 to November, 2008 and June, 2010 to July, 2011 and the subsequent thyroidectomy specimens.
Results
Post‐Bethesda System, diagnoses that are equivocal for diverse reasons and which have wide‐ranging PPVs are now all grouped into the AUS category, and the proportion of cases that are in the atypical/AUS category rose from 3.7% in the pre‐Bethesda period to 12% in the post‐Bethesda period.
Conclusion
The AUS category has a PPV approaching 50% in our lab. This creates uncertainty regarding the appropriate management for this category and may cause unnecessary overuse of molecular testing for cases in the AUS category. Diagn. Cytopathol. 2015;43:28–31. © 2014 Wiley Periodicals, Inc.</description><subject>Adenoma, Oxyphilic</subject><subject>atypia</subject><subject>Bethesda System</subject><subject>Biopsy, Fine-Needle - methods</subject><subject>Biopsy, Fine-Needle - standards</subject><subject>Carcinoma - classification</subject><subject>Carcinoma - pathology</subject><subject>Diagnosis, Differential</subject><subject>FNA</subject><subject>Humans</subject><subject>Medical Records</subject><subject>National Cancer Institute (U.S.)</subject><subject>Sensitivity and Specificity</subject><subject>thyroid</subject><subject>Thyroid Neoplasms - classification</subject><subject>Thyroid Neoplasms - pathology</subject><subject>undetermined significance</subject><subject>United States</subject><issn>8755-1039</issn><issn>1097-0339</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp10EFrFDEYxvEgil2r4CeQgAe9TH0zmZkkx7raKtQVyoriJWSSdzR1ZjImGex-e2fttoLgJbn8-PPyEPKUwQkDKF85e1JyJst7ZMVAiQI4V_fJSoq6LhhwdUQepXQFAKpkzUNyVFay4QByRfwlTiFmP36j-fsuBu_o2eaUttiFiNSMjpouY6R-mHoccMwm-zDS0C0c6Wtc3uQMTbuUcSjCiNSPKfs879mLRPF6wuhxtPiYPOhMn_DJ4T8mn87ebtfviouP5-_XpxeF5VKUhVAM0DlR1a1STAEvrapBOVkzrK1zgEa2kjNmwZi2dWAaU0lpBTCsuKn4MXl5051i-DljynrwyWLfmxHDnDRruKhFxRqx0Of_0Kswx3G5bq9qrpa9yr9BG0NKETs9RT-YuNMM9H5-7az-M_9Cnx2Cczugu4O3ey-guAG_fI-7_4b0m_Vt8OD9su_1nTfxh17uF7X-vDnXW_ZFfd1sP-hL_hsUlZyr</recordid><startdate>201501</startdate><enddate>201501</enddate><creator>Brister, Kathriel J.</creator><creator>Singh, Remmi S.</creator><creator>Wang, Helen H.</creator><general>Blackwell Publishing Ltd</general><general>Wiley Subscription Services, Inc</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>7X8</scope></search><sort><creationdate>201501</creationdate><title>Reporting thyroid FNA before and after implementation of the Bethesda system-one institution's experience</title><author>Brister, Kathriel J. ; Singh, Remmi S. ; Wang, Helen H.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3872-7910edd745b9919032c9509d851e5cdd0ea8b8311c0aabbd0a6a488c701e43a43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Adenoma, Oxyphilic</topic><topic>atypia</topic><topic>Bethesda System</topic><topic>Biopsy, Fine-Needle - methods</topic><topic>Biopsy, Fine-Needle - standards</topic><topic>Carcinoma - classification</topic><topic>Carcinoma - pathology</topic><topic>Diagnosis, Differential</topic><topic>FNA</topic><topic>Humans</topic><topic>Medical Records</topic><topic>National Cancer Institute (U.S.)</topic><topic>Sensitivity and Specificity</topic><topic>thyroid</topic><topic>Thyroid Neoplasms - classification</topic><topic>Thyroid Neoplasms - pathology</topic><topic>undetermined significance</topic><topic>United States</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Brister, Kathriel J.</creatorcontrib><creatorcontrib>Singh, Remmi S.</creatorcontrib><creatorcontrib>Wang, Helen H.</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Diagnostic cytopathology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Brister, Kathriel J.</au><au>Singh, Remmi S.</au><au>Wang, Helen H.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Reporting thyroid FNA before and after implementation of the Bethesda system-one institution's experience</atitle><jtitle>Diagnostic cytopathology</jtitle><addtitle>Diagn. Cytopathol</addtitle><date>2015-01</date><risdate>2015</risdate><volume>43</volume><issue>1</issue><spage>28</spage><epage>31</epage><pages>28-31</pages><issn>8755-1039</issn><eissn>1097-0339</eissn><abstract>Background
The Bethesda System for Reporting Thyroid Cytopathology was published in 2008 and was implemented at Beth Israel Deaconess Medical Center (BIDMC) in June, 2010. Prior to this date, our diagnostic scheme was similar to the Bethesda System, except for the category of “Atypia/Follicular Lesion of Undetermined Significance” (AUS). This study evaluates the impact of the Bethesda System on the rate and the positive predictive value (PPV) of the diagnostic categories at BIDMC.
Methods
We performed a retrospective review of all thyroid fine‐needle aspirations (FNAs) during the time periods January, 2006 to November, 2008 and June, 2010 to July, 2011 and the subsequent thyroidectomy specimens.
Results
Post‐Bethesda System, diagnoses that are equivocal for diverse reasons and which have wide‐ranging PPVs are now all grouped into the AUS category, and the proportion of cases that are in the atypical/AUS category rose from 3.7% in the pre‐Bethesda period to 12% in the post‐Bethesda period.
Conclusion
The AUS category has a PPV approaching 50% in our lab. This creates uncertainty regarding the appropriate management for this category and may cause unnecessary overuse of molecular testing for cases in the AUS category. Diagn. Cytopathol. 2015;43:28–31. © 2014 Wiley Periodicals, Inc.</abstract><cop>United States</cop><pub>Blackwell Publishing Ltd</pub><pmid>24863008</pmid><doi>10.1002/dc.23182</doi><tpages>4</tpages></addata></record> |
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| subjects | Adenoma, Oxyphilic atypia Bethesda System Biopsy, Fine-Needle - methods Biopsy, Fine-Needle - standards Carcinoma - classification Carcinoma - pathology Diagnosis, Differential FNA Humans Medical Records National Cancer Institute (U.S.) Sensitivity and Specificity thyroid Thyroid Neoplasms - classification Thyroid Neoplasms - pathology undetermined significance United States |
| title | Reporting thyroid FNA before and after implementation of the Bethesda system-one institution's experience |
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