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Related Experiment Videos

Adequacy criteria for thyroid FNA evaluated by ThinPrep slides only.

Marina Vivero1, Andrew A Renshaw2, Jeffrey F Krane1

  • 1Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.

Cancer Cytopathology
|April 8, 2017
PubMed
Summary

Lowering adequacy criteria for thyroid fine-needle aspiration (FNA) using ThinPreps (TPs) did not impact test performance, especially when malignancy-associated features were absent. This aids in diagnosing thyroid nodules.

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Area of Science:

  • Cytopathology
  • Endocrinology
  • Surgical Pathology

Background:

  • Thyroid fine-needle aspiration (FNA) adequacy criteria, established by The Bethesda System for Reporting Thyroid Cytopathology (TBS), were based on smears.
  • These criteria are frequently applied to ThinPreps (TPs), a different sample preparation method.
  • This study investigates the impact of adjusting adequacy thresholds for TPs.

Purpose of the Study:

  • To evaluate the diagnostic adequacy of thyroid fine-needle aspiration (FNA) using ThinPreps (TPs) under modified criteria.
  • To determine if altering the cell count and group requirements affects the diagnostic accuracy of thyroid FNAs.
  • To correlate cytological features in initially nondiagnostic cases with final surgical outcomes.

Main Methods:

  • Analysis of FNA procedures with matched surgical specimens from 2010-2015.
Keywords:
Bethesdaadequacyatypiafine-needle aspirationnondiagnosticthyroid

Related Experiment Videos

  • Evaluation of cell counts and cytological features in initially nondiagnostic (ND) cases.
  • Reclassification of ND cases by two pathologists and comparison with surgical outcomes.

    • Main Results:

    • Lowering the diagnostic threshold to include any follicular cells in TPs maintained high sensitivity (92%) and negative predictive value (92%).
    • Interobserver agreement for reclassifying ND cases was moderate (k=0.57).
    • Specific cytological features like nuclear enlargement and grooves in ND FNAs correlated with malignancy.

    Conclusions:

    • Modifying thyroid FNA adequacy criteria for TPs, including lowering thresholds and removing group requirements, did not significantly alter test performance when malignancy-associated features were absent.
    • This suggests a potential for more flexible adequacy assessment in TP thyroid FNAs.
    • Cytological assessment remains crucial for identifying potentially malignant cases.