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Usefulness of The Bethesda System of Reporting Thyroid Cytopathology in Surgical Planning

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Abstract

The Bethesda system for reporting thyroid cytopathology (TBSRTC) has attempted to standardize thyroid fine needle aspiration cytology (FNAC) reporting internationally into six diagnostic categories and help in clinical decision making. But there exists a significant variation in the reporting percentage and rates of malignancies in each category across the centres which complicates clinical decision making. To study the usefulness of TBSRTC in surgical planning of thyroid nodules and to correlate TBSRTC with final histopathology. 85 patients with thyroid nodules who underwent surgery were evaluated prospectively. Preoperatively FNAC and TBSRTC reporting was done and following surgery histopathology was correlated with cytology. Distribution of 85 patients amongst the six categories of TBSRTC was as follows: 2.35% in Category I, 68.23% II, 7.05% III, 16.47% IV, 2.35% V and 3.52% VI. In 93% (79) of patients TBSRTC correlated with histopathology whereas in 7% (6) it did not. Risk of malignancy calculated was 0% in II, 33.33% in III, 7.14% in IV and 100% in V and VI categories. Sensitivity, specificity, Positive Predictive Value and Negative Predictive Value of TBSRTC was 100% for V, VI categories, whereas it was 100%, 78%, 15% and 100% respectively for III, IV. The diagnostic accuracy in our study is 100% for Category V and VI whereas it is 79% for Category III and IV. TBSRTC proved to be a very good screening platform for triaging patients with thyroid nodules into benign and malignant groups, as it is directly related to risk of malignancy in each category. It has helped in appropriate surgical planning in 96.4% of our patients.

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References

  1. Arul P, Akshatha C, Masilamani S (2015) A study of malignancy rates in different diagnostic categories of the Bethesda system for reporting thyroid cytopathology: An institutional experience. Biomed J 38(6):517–522

    Article  CAS  PubMed  Google Scholar 

  2. Tessler FN, Middleton WD, Grant EG, Hoang JK, Berland LL, Teefey SA et al (2017) ACR thyroid imaging, reporting and data system (TI-RADS): white paper of the ACR TI-RADS Committee. J Am CollRadiol JACR 14(5):587–595

    Article  PubMed  Google Scholar 

  3. Haugen BR, Alexander EK, Bible KC, Doherty GM, Mandel SJ, Nikiforov YE et al (2016) 2015 American Thyroid Association Management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: the American Thyroid Association Guidelines task force on thyroid nodules and differentiated thyroid cancer. Thyroid 26(1):1–133

    Article  PubMed  PubMed Central  Google Scholar 

  4. Melo-Uribe MA, Sanabria Á, Romero-Rojas A, Pérez G, Vargas EJ, Abaúnza MC et al (2015) The Bethesda system for reporting thyroid cytopathology in Colombia: correlation with histopathological diagnoses in oncology and non-oncology institutions. J Cytol Indian AcadCytol 32(1):12–16

    Article  Google Scholar 

  5. Cibas ES, Ali SZ (2009) NCI Thyroid FNA state of the science conference. The Bethesda System for reporting thyroid cytopathology. Am J ClinPathol 132(5):658–65

    Google Scholar 

  6. Cesur M, Corapcioglu D, Bulut S, Gursoy A, Yilmaz AE, Erdogan N et al (2006) Comparison of palpation-guided fine-needle aspiration biopsy to ultrasound-guided fine-needle aspiration biopsy in the evaluation of thyroid nodules. Thyroid Off J Am Thyroid Assoc 16(6):555–561

    Article  Google Scholar 

  7. Anand B, Ramdas A, Ambroise MM, Kumar NP (2020) The bethesda system for reporting thyroid cytopathology: a cytohistological study. J Thyroid Res 16(2020):1–8

    Article  Google Scholar 

  8. Yoon JH, Kwak JY, Moon HJ, Kim MJ, Kim E-K (2011) The diagnostic accuracy of ultrasound-guided fine-needle aspiration biopsy and the sonographic differences between benign and malignant thyroid nodules 3 cm or larger. Thyroid Off J Am Thyroid Assoc 21(9):993–1000

    Article  Google Scholar 

  9. Stulak JM, Grant CS, Farley DR, Thompson GB, Heerden JAV, Hay ID et al (2006) Value of preoperative ultrasonography in the surgical management of initial and reoperative papillary thyroid cancer. Arch Surg 141(5):489–496

    Article  PubMed  Google Scholar 

  10. Solorzano CC, Carneiro DM, Ramirez M, Lee TM, Irvin GL (2004) Surgeon-performed ultrasound in the management of thyroid malignancy. Am Surg 70(7):576–580. (discussion 580–582)

    PubMed  Google Scholar 

  11. Mehta S, Kannan S (2020) Approaching indeterminate thyroid nodules in the absence of molecular markers: “The BETH-TR score.” Indian J EndocrinolMetab 24(2):170

    Article  Google Scholar 

  12. Middleton WD, Teefey SA, Reading CC, Langer JE, Beland MD, Szabunio MM et al (2018) Comparison of performance characteristics of American College of Radiology TI-RADS, Korean Society of Thyroid Radiology TIRADS, and American Thyroid Association Guidelines. AJR Am J Roentgenol 210(5):1148–1154

    Article  PubMed  Google Scholar 

  13. Nayar R, Ivanovic M (2009) The indeterminate thyroid fine-needle aspiration: experience from an academic center using terminology similar to that proposed in the 2007 national cancer institute thyroid fine needle aspiration state of the science conference. Cancer Cytopathol 117(3):195–202

    Article  Google Scholar 

  14. Muratli A, Erdogan N, Sevim S, Unal I, Akyuz S (2014) Diagnostic efficacy and importance of fine-needle aspiration cytology of thyroid nodules. J Cytol Indian AcadCytol 31(2):73–78

    Article  Google Scholar 

  15. Basharat R, Bukhari MH, Saeed S, Hamid T (2011) Comparison of fine needle aspiration cytology and thyroid scan in solitary thyroid nodule. Pathol Res Int 2011:754041

    Article  Google Scholar 

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Authors and Affiliations

  1. Department of ENT and Head and Neck Surgery, Bangalore Baptist Hospital, Bellary Road, Hebbal, Bengaluru, Karnataka, 560024, India

    Swetal Mahajan, B. V. Manjula, R. Vaishnavi & Bhuvaneshwari Babu

  2. Pathology, Bangalore Baptist Hospital, Bengaluru, Karnataka, India

    Neena John

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  1. Swetal Mahajan
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  2. B. V. Manjula
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  3. R. Vaishnavi
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  4. Neena John
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  5. Bhuvaneshwari Babu
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Correspondence to B. V. Manjula.

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Mahajan, S., Manjula, B.V., Vaishnavi, R. et al. Usefulness of The Bethesda System of Reporting Thyroid Cytopathology in Surgical Planning. Indian J Otolaryngol Head Neck Surg 74 (Suppl 2), 2623–2628 (2022). https://doi.org/10.1007/s12070-020-02335-5

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