OBJECTIVES: To evaluate the diagnostic accuracy of fine-needle aspiration biopsy (FNAB) to preoperatively diagnose medullary thyroid cancer (MTC) among multiple international centers and evaluate how the cytological diagnosis alone could impact patient management. METHODS: We performed a retrospective chart review of sporadic MTC (sMTC) patients from 12 institutions over the last 29 years. FNAB cytology results were compared to final pathologic diagnoses to calculate FNAB sensitivity. To evaluate the impact of cytology sensitivity for MTC according to current practice and to avoid confounding results by local treatment protocols, changes in treatment patterns over time, and the influence of ancillary findings (e.g., serum calcitonin), therapeutic interventions based on FNAB cytology alone were projected into 1 of 4 treatment categories: total thyroidectomy (TT) and central neck dissection (CND), TT without CND, diagnostic hemithyroidectomy, or observation. RESULTS: A total of 313 patients from 4 continents and 7 countries were included, 245 of whom underwent FNAB. FNAB cytology revealed MTC in 43.7% and possible MTC in an additional 2.4%. A total of 113 (46.1%) patients with surgical pathology revealing sMTC had FNAB findings that supported TT with CND, while 37 (15.1%) supported TT alone. In the remaining cases, diagnostic hemithyroidectomy and observation were projected in 32.7% and 6.1%, respectively. CONCLUSION: FNAB is an important diagnostic tool in the evaluation of thyroid nodules, but the low sensitivity of cytological evaluation alone in sMTC limits its ability to command an optimal preoperative evaluation and initial surgery in over half of affected patients.
OBJECTIVES: To evaluate the diagnostic accuracy of fine-needle aspiration biopsy (FNAB) to preoperatively diagnose medullary thyroid cancer (MTC) among multiple international centers and evaluate how the cytological diagnosis alone could impact patient management. METHODS: We performed a retrospective chart review of sporadic MTC (sMTC) patients from 12 institutions over the last 29 years. FNAB cytology results were compared to final pathologic diagnoses to calculate FNAB sensitivity. To evaluate the impact of cytology sensitivity for MTC according to current practice and to avoid confounding results by local treatment protocols, changes in treatment patterns over time, and the influence of ancillary findings (e.g., serum calcitonin), therapeutic interventions based on FNAB cytology alone were projected into 1 of 4 treatment categories: total thyroidectomy (TT) and central neck dissection (CND), TT without CND, diagnostic hemithyroidectomy, or observation. RESULTS: A total of 313 patients from 4 continents and 7 countries were included, 245 of whom underwent FNAB. FNAB cytology revealed MTC in 43.7% and possible MTC in an additional 2.4%. A total of 113 (46.1%) patients with surgical pathology revealing sMTC had FNAB findings that supported TT with CND, while 37 (15.1%) supported TT alone. In the remaining cases, diagnostic hemithyroidectomy and observation were projected in 32.7% and 6.1%, respectively. CONCLUSION: FNAB is an important diagnostic tool in the evaluation of thyroid nodules, but the low sensitivity of cytological evaluation alone in sMTC limits its ability to command an optimal preoperative evaluation and initial surgery in over half of affected patients.
Authors: E J Ha; J H Baek; D G Na; J-h Kim; J K Kim; H S Min; D E Song; K E Lee; Y K Shong Journal: AJNR Am J Neuroradiol Date: 2015-04-30 Impact factor: 3.825
Authors: Reese W Randle; Courtney J Balentine; Glen E Leverson; Jeffrey A Havlena; Rebecca S Sippel; David F Schneider; Susan C Pitt Journal: Surgery Date: 2016-11-11 Impact factor: 3.982
Authors: Garth F Essig; Kyle Porter; David Schneider; Debora Arpaia; Susan C Lindsey; Giulia Busonero; Daniel Fineberg; Barbara Fruci; Kristien Boelaert; Johannes W Smit; Johannes Arnoldus Anthonius Meijer; Leonidas H Duntas; Neil Sharma; Giuseppe Costante; Sebastiano Filetti; Rebecca S Sippel; Bernadette Biondi; Duncan J Topliss; Furio Pacini; Rui M B Maciel; Patrick C Walz; Richard T Kloos Journal: Thyroid Date: 2016-10-11 Impact factor: 6.568
Authors: Sergiy V Kushchayev; Yevgeniya S Kushchayeva; Sri Harsha Tella; Tetiana Glushko; Karel Pacak; Oleg M Teytelboym Journal: J Thyroid Res Date: 2019-07-07