Evidence map›Paper›PMID 29350311›Full record

ArticleEndocrine2018

Shear wave elastography and Afirma™ gene expression classifier in thyroid nodules with indeterminate cytology: a comparison study.

Ghobad Azizi, James M Keller, Michelle L Mayo, Kelé Piper, David Puett, Karly M Earp, Carl D Malchoff

Abstract readComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Endocrine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
17citing papers in PubMed, 3 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

17 citing papers in PubMed, 3 syntheses or guidelines pooled it.

  1. Pooled it
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  13. Features of Cytologically Indeterminate Molecularly Benign Nodules Treated With Surgery.The Journal of clinical endocrinology and metabolism · 2020
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Ghobad AziziWilmington Endocrinology, 1717 Shipyard Boulevard, Wilmington, NC, 28403, USA. azizi@wilmingtonendo.com.ORCID http://orcid.org/0000-0002-7833-7450
James M KellerWilmington Pathology Associates, 1915 South 17th Street, Suite 100, Wilmington, NC, 28401, USA.
Michelle L MayoWilmington Endocrinology, 1717 Shipyard Boulevard, Wilmington, NC, 28403, USA.
Kelé PiperBeth Israel Deaconess Medical Center, 109 Brookline, Suite 200, Boston, MA, 02215, USA.
David PuettCarolina Arthritis, 1710 South 17th Street, Wilmington, NC, 28401, USA.
Karly M EarpWilmington Endocrinology, 1717 Shipyard Boulevard, Wilmington, NC, 28403, USA.
Carl D MalchoffUConn Health, 263 Farmington Avenue, Farmington, CT, 06030, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTo compare shear wave elastography (SWE) and Afirma™ gene expression classifier (GEC) for diagnosis of malignancy in thyroid nodules (TNs) with Bethesda Classification (BC) III or IV indeterminate cytology.

methodsThis preliminary single-center prospective study was approved by the Institutional Review Board. We evaluated 151 consented patients with 151 indeterminate TNs (123 BC III, 28 BC IV) on fine-needle aspiration biopsy (FNAB). B-mode ultrasound, vascularity, and SWE were performed prior to FNAB. TN stiffness was measured as shear wave velocity (SWV) in meters per second (m/s). The stiffest area of the TN was selected for SWV measurement. GEC testing was performed with a second FNAB. Surgery was recommended for GEC-suspicious TNs, or GEC-benign TNs with two or more worrisome B-mode US features.

resultsSurgical pathology confirmed 31 malignant TNs. Among the GEC-suspicious group, 28 of 59 TNs were malignant. The SWV value of ≥3.59 m/s was the best cut-off for malignancy risk based on the receiver operating curve (ROC). Twenty-six malignant TNs had SWV ≥ 3.59 m/s. The sensitivity and specificity for SWV ≥ 3.59 m/s were 83.9 and 79.2%, respectively. Positive predictive value (PPV) was 51.0% and negative predictive value (NPV) was 95.0%. For the GEC-suspicious group, sensitivity, specificity, PPV, and NPV were 90.3, 74.2, 47.5, and 96.7%, respectively. In multivariate analysis, SWV and GEC-suspicious were significant predictors of malignancy, but B-mode features and vascularity were not.

conclusionThis preliminary study indicates that SWE and GEC are independent predictors of malignancy in TNs with BC III or IV.

Indexed as

AdultAgedBiopsy, Fine-NeedleElasticity Imaging TechniquesFemaleGene Expression ProfilingHumansMaleMiddle AgedProspective StudiesSensitivity and SpecificityThyroid GlandThyroid NoduleGEC testingIndeterminate FNABShear wave elastographyThyroid noduleUltrasound

Identifiers

PMID29350311
PMCPMC5847162

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.