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Assessing the diagnostic performance of thyroid biopsy with recommendations for appropriate interpretation

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Abstract
Purpose: The diagnostic performance of thyroid biopsy is influenced by several factors, including differences in the Bethesda categorization for malignancy, the inclusion or exclusion of non-diagnostic results, the definition used for the final diagnosis, and the definition of an inconclusive diagnosis. The purpose of this study was to provide an understanding of the factors influencing the diagnostic performance of thyroid biopsy.

Methods: We collected data retrospectively between January and December 2013 from a cohort of 6,762 thyroid nodules from 6,493 consecutive patients who underwent biopsy. In total, 4,822 nodules from 4,553 patients were included. We calculated the biopsy sensitivity according to the inclusion of different Bethesda categories in the numerator and the exclusion of non-diagnostic results, as well as the diagnostic accuracy according to different definitions of a benign diagnosis. We obtained the conclusive and inconclusive diagnosis rates.

Results: The sensitivity increased when more Bethesda categories were included in the numerator and when non-diagnostic results were excluded. When a benign thyroid nodule diagnosis was defined as benign findings on surgical resection, concordant benign results on at least two occasions, or an initial benign biopsy result and follow-up for more than 12 months, the accuracy was higher than when the diagnosis was based on surgical resection alone (91.1% vs. 68.7%). A higher conclusive diagnosis rate was obtained when Bethesda categories I and III were considered inconclusive than when Bethesda categories I, III and IV were considered inconclusive (78.3% vs. 72.8%, P<0.001).

Conclusion: Understanding the concepts presented herein is important in order to appropriately interpret the diagnostic performance of thyroid biopsy.
Author(s)
나동규백정환서종현성태연송동은송영기이정현정찬권하수민
Issued Date
2021
Type
Article
Keyword
BiopsyDiagnosisOriginalThyroid neoplasmsThyroid noduleUltrasonography방사선과학
DOI
10.14366/usg.19099
URI
https://oak.ulsan.ac.kr/handle/2021.oak/7876
https://ulsan-primo.hosted.exlibrisgroup.com/primo-explore/fulldisplay?docid=TN_cdi_nrf_kci_oai_kci_go_kr_ARTI_9770190&amp;context=PC&amp;vid=ULSAN&amp;lang=ko_KR&amp;search_scope=default_scope&amp;adaptor=primo_central_multiple_fe&amp;tab=default_tab&amp;query=any,contains,Assessing%20the%20diagnostic%20performance%20of%20thyroid%20biopsy%20with%20recommendations%20for%20appropriate%20interpretation&amp;offset=0&amp;pcAvailability=true
Publisher
ULTRASONOGRAPHY
Location
대한민국
Language
영어
ISSN
2288-5919
Citation Volume
40
Citation Number
2
Citation Start Page
228
Citation End Page
236
Appears in Collections:
Medicine > Medicine
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