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Updated: Jan 15, 2026
A Swin Transformer-Based Model for Thyroid Nodule Detection in Ultrasound Images
Published on: April 21, 2023
Performance of molecular testing for indeterminate thyroid nodules in Black patients
Zhixing Song1, Ramsha Akund1, Christopher Wu1
1Department of Surgery, University of Alabama at Birmingham, Birmingham, AL, USA.
Introduction:
Current molecular testing of thyroid nodules assesses malignancy risk without considering racial genetic variations, possibly introducing bias.
Methods:
We conducted a retrospective analysis of 2905 patients who underwent fine needle aspiration (FNA) for thyroid nodules from 2015 to 2023. Indeterminate nodules were classified as Bethesda III and IV. The performance of molecular testing was assessed by comparing Afirma test results with histopathological findings.
Results:
Among 662 patients with indeterminate FNA results, 173 (26.7 %) were Black and 474 (73.3 %) were White. The benign call rate was higher in Black patients (45.7 % vs. 34.7 %, p = 0.035). Malignancy rates based on surgical pathology were 16.7 % for nodules classified as benign by molecular testing in Black patients and 7.7 % in White patients (p = 0.574). There was a trend toward lower sensitivity (88.5 % vs. 96.1 %, p = 0.349) and negative predictive value (84.6 % vs. 90 %, p = 0.492) in molecular testing for Black patients.
Conclusions:
Molecular testing might miss thyroid cancers in Black patients, potentially impacting prognosis. Surgeons should carefully interpret molecular testing results as part of holistic thyroid nodule treatment.
