Application of the Bethesda System for Reporting Thyroid Cytopathology in the Eastern Province of Saudi Arabia: A Follow-Up Study

Abstract

This is a follow-up study to our previous analysis of thyroid aspirates utilizing the Bethesda System for Reporting Thyroid Cytology (BSRTC). The same study design was utilized for 2 years comparing 2 periods. A total of 251 thyroid aspirates from 218 patients were reviewed and deemed comparable to the previous cohort. The variance and consequently the number of interpretations dropped from 26 to 11 with a statistically significant 58% reduction and more consistency. Our unsatisfactory rate dropped from 22 to 10% (reduction of 55%). The risk of malignancy in this follow-up study showed a similar trend: an increase in risk with each step up in the BSRTC categories starting from the ‘nondiagnostic' and up to ‘malignant'. Few of our benign cases ended up with resection. We noticed sensitivity to the word ‘follicular' in this benign category; therefore we propose a modification of the current BSRTC system by omitting the word ‘follicular' from the benign category. We strongly believe that this modification harbors no serious damage to the intentions of BSRTC. This follow-up study has shown that the previous awareness campaign about the implementation has worked and can be considered a valid performance improvement program.

A follow‐up study on thyroid aspirates reported as atypia of undetermined significance/follicular lesion of undetermined significance and follicular neoplasm/suspicious for follicular neoplasm: A multicenter study from the Arabian Gulf region

“…15 This was followed up by another study showing the impact of the initial campaign and its impact on the major key performance indicators. 16 As evidenced by the results of our second follow-up study, the awareness and acceptance of TBSRTC has dramatically increased with statistically significant improvement and demonstrable changes. 16…”

“…16 As evidenced by the results of our second follow-up study, the awareness and acceptance of TBSRTC has dramatically increased with statistically significant improvement and demonstrable changes. 16…”

“…[10][11][12][13][14][15] In the first study, revision and reclassification of 205 thyroid aspirates were carried out, followed by completion of an extensive awareness campaign for pathologists and clinicians highlighting the utility and implications of the Bethesda system. 16 16 …”

“…As evidenced by the results of our second follow-up study, the awareness and acceptance of TBSRTC has dramatically increased with statistically significant improvement and demonstrable changes 16. An approval for this study from the Internal Review Board (IRB) for each participating institution was granted before commencing the study.…”

Bethesda Made It Clearer: A Review of 542 Patients in a Single Institution

“…An evaluation of the Bethesda system with regard to its contribution to establishing a common terminology demonstrated that diagnostic controversies among pathologists had dwindled to 11% compared to more than a quarter of cases. Furthermore, the rates of nondiagnostic or unsatisfactory reports had been almost halved [13].…”