ArticleIndian journal of endocrinology and metabolism
Approaching Indeterminate Thyroid Nodules in the Absence of Molecular Markers: "The BETH-TR Score".
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5 citing papers in PubMed, 1 synthesis or guideline pooled it, 13 citations in OpenAlex.
- Diagnostic performance of ultrasound risk stratification systems on thyroid nodules cytologically classified as indeterminate: a systematic review and meta-analysis.Ultrasonography (Seoul, Korea) · 2023Pooled it
- Risk assessment of cytologically indeterminate thyroid nodules with integrated molecular testing and repeat biopsy: a surgical decision-oriented tool.World journal of surgical oncology · 2023Article
- Usefulness of The Bethesda System of Reporting Thyroid Cytopathology in Surgical Planning.Indian journal of otolaryngology and head and neck surgery : official publication of the Association of Otolaryngologists of India · 2022Article
- Role of Genetic Testing in the Management of Indeterminate Thyroid Nodules in the Indian Setting.Indian journal of endocrinology and metabolismReview
- Prospective Validation of Accuracy of American College of Radiologists- Thyroid Imaging Reporting and Data System (ACR-TIRADS) in Diagnosing Malignancy in Thyroid Nodule and a Prediction Score (TiPS) for Thyroid Malignancy.Indian journal of endocrinology and metabolismArticle
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2 authors at 1 institution in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
contextGiven the lack of easy access to molecular markers for indeterminate thyroid nodules (Bethesda (BETH) category III, IV), the clinician can either decide to get a second opinion from an expert high-volume thyroid cytopathologist, redo the FNAC after a period of 3-6 months, or send the patient for a diagnostic hemithyroidectomy. Reviewing the sonographic risk features is also one way of triaging these nodules. The ACR-TIRADS (TR) is an objective method of sonographic risk assessment and is superior to other forms of sonographic classification.
aimWe propose combining the scoring of the TR category and BETH category (both expressed as a numerical value and summated) and look at the score which could potentially guide the clinician in deciding whom to send for surgery. SETTINGS AND
designObservational prospective collection of consecutive patient data from the thyroid FNAC clinic. STATISTICAL ANALYSIS USED: The BETH categories were represented numerically and summated with the TR category. The categorical outcome variables of benign and malignant nodules and the summated score was analyzed using the Kruskal-Wallis test.
resultsWe analyzed 450 FNAC data, out of which 403 were thyroid nodule aspirates. Out of these nodules, 96 of them underwent surgery and 64% of these nodules were malignant on final histopathology (malignant = 62 and benign = 34). The mean size of the benign nodules was 3.6 ± 2.2 cm compared to 2.8 ± 1.8 cm of the malignant nodules. After excluding those with BETH 1 (
conclusionA combined sonocytological BETH-TR score is one way to triage the management of indeterminate thyroid nodules. A BETH-TR score ≥7 gave a sensitivity of 92% specificity of 74% and correctly identified malignant nodules in 86% of cases.
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