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Differences in cytopathologist thyroid nodule malignancy rate.

Ohad Ronen1, Hector Cohen2, Eyal Sela1

  • 1Department of Otolaryngology - Head and Neck Surgery, Galilee Medical Center, Nahariya, Israel.

Cytopathology : Official Journal of the British Society for Clinical Cytology
|April 26, 2020
PubMed
Summary

Interobserver variability exists in thyroid nodule cytopathology, impacting malignancy rate assessments. Awareness of these differences is crucial for accurate clinical interpretation of fine needle aspiration results.

Keywords:
fine needle aspirationinterobserver agreementthyroid cancerthyroid nodule

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Area of Science:

  • Endocrinology
  • Pathology
  • Cytopathology

Background:

  • Fine needle aspiration (FNA) accuracy for thyroid nodules depends on technique and expertise.
  • Interobserver variability can affect cytological diagnoses.

Purpose of the Study:

  • To evaluate interobserver differences in thyroid nodule cytopathology.
  • To assess the impact of variability on malignancy rates within the Thyroid Bethesda System (TBS) categories.

Main Methods:

  • Retrospective analysis of 287 thyroid nodule FNA reports from August 2013 to September 2017.
  • Comparison of sensitivity, specificity, predictive values, and accuracy between two cytopathologists.
  • Analysis of malignancy rates across different TBS categories.

Main Results:

  • Significant differences were observed in the utilization of TBS category 3 (8.0% vs 21.2%, P=.01).
  • Malignancy rates in TBS category 3 showed variability (40% vs 17%, P=.545).
  • Overall interobserver differences in thyroid nodule evaluation were identified.

Conclusions:

  • Interobserver variability in thyroid nodule cytopathology is present.
  • These differences influence the calculated malignancy rates for specific TBS categories.
  • Clinicians must consider this variability when interpreting FNA results for thyroid nodules.