Reproducibility of atypia of undetermined significance/follicular lesion of undetermined significance category using the bethesda system for reporting thyroid cytology when reviewing slides from different institutions: A study of interobserver variability among cytopathologists

Padmanabhan, Vijayalakshmi; Marshall, Carrie B.; Barkan, Güliz A.; Ghofrani, Mohiedean; Laser, Alice; Ocal, Idris Tolgay; Sturgis, Charles D.; Souers, Rhona J.; Kurtycz, Daniel F.I.

doi:10.1002/dc.23681

Cited by 45 publications

(32 citation statements)

References 34 publications

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“…Our study differed from a study done by Padmanabhan et al which assessed the interobserver reproducibility in reporting AUS/FLUS category among seven cytopathologists which revealed fair agreement (Fleiss kappa score 0.23) and recommended review of AUS/FLUS cases for more Journal of yroid Research definite categorization [25]. We observed a trend that the less the number of observers (2-3), the more the chance of interobserver agreement (Table 5).…”

Section: Discussioncontrasting

confidence: 90%

“…e main purpose of TBSRTC was to eliminate the ambiguity and to follow uniformity in the reporting of thyroid FNAs thereby enabling ease of communication among pathologists and clinician and to plan appropriate treatment for the patients [2]. Table 5 shows comparison of interobserver reproducibility of our study with that of other studies [23][24][25].…”

Section: Discussionmentioning

confidence: 94%

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The Bethesda System for Reporting Thyroid Cytopathology: A Cytohistological Study

Anand

Ramdas

Ambroise

et al. 2020

Journal of Thyroid Research

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Introduction. The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) is a significant step to standardize the reporting of thyroid fine needle aspiration (FNA). It has high predictive value, reproducibility, and improved clinical significance. Aim. The study was aimed to evaluate the diagnostic utility and reproducibility of “TBSRTC” at our institute. Methods and Material. The study included 646 thyroid FNAs which were reviewed by three pathologists and classified according to TBSRTC. Cytohistological correlation was done for 100 cases with surgical follow-up and the sensitivity, specificity, positive predictive value, negative predictive value, diagnostic accuracy, and risk of malignancy (ROM) were calculated. The interobserver variation among three pathologists was also assessed. Results. The distribution of cases in various TBSRTC categories is as follows: I—nondiagnostic 13.8%, II—benign 75.9%, III—atypia of undetermined significance (AUS)/follicular lesion of undetermined significance (FLUS) 1.2%, IV—follicular neoplasm (FN)/suspicious for follicular neoplasm (SFN) 3.7%, V—suspicious for malignancy (SM) 2.6%, and VI—malignant 2.8%. The sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy are 72.4%, 94.3%, 84%, 89.2%, and 87.9%, respectively. The ROM of various TBSRTC categories were II—8.5%; III—66.7%; IV—63.6%; and V and VI—100%. Cohen’s Weighted Kappa score was 0.99 which indicates almost perfect agreement among the three pathologists. Conclusions. Our study substantiates greater reproducibility among pathologists using TBSRTC to arrive at a precise diagnosis with an added advantage of predicting the risk of malignancy which enables the clinician to plan for follow-up or surgery and also the extent of surgery.

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Section: Discussioncontrasting

confidence: 90%

Section: Discussionmentioning

confidence: 94%

The Bethesda System for Reporting Thyroid Cytopathology: A Cytohistological Study

Anand

Ramdas

Ambroise

et al. 2020

Journal of Thyroid Research

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“…This could be due to unfamiliarity with the diagnostic category. Low IOR is not an uncommon finding within ambiguous diagnostic categories such as those observed in TBSRCC and TBSRTC . A study by Gatscha et al looked at 632 cervicovaginal smears diagnosed as atypical squamous cells of undetermined significance and had 3 observers rescreen these specimens.…”

Section: Discussionmentioning

confidence: 99%

“…Indeterminate categories in TBSRCC are atypical squamous cells of undetermined significance and atypical squamous cells, cannot exclude high grade squamous intraepithelial lesion, whereas the indeterminate categories in TBSRTC include atypia of undetermined significance/follicular lesion of undetermined significance and suspicious for malignancy. Studies have shown that these ambiguous categories have poor interobserver reliability (IOR), especially in cases with limited cellularity or only focal atypia . In addition, TBSRCC and TBSRTC contain well‐defined adequacy criteria for the interpretation of direct smears that establish a minimum baseline cellularity for evaluation and are a measure of quality assurance for each procedure.…”

Section: Introductionmentioning

confidence: 99%

Northern Italy in the American South: Assessing interobserver reliability within the Milan System for Reporting Salivary Gland Cytopathology

Hollyfield

O’Connor

Maygarden

et al. 2018

Cancer Cytopathology

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In this study assessing the IOR of MSRSGC categories, fair agreement and slight agreement were found for the AUS and SUMP categories, respectively. Observers preferentially used the AUS or benign neoplasm category for SUMP cases, perhaps because of unfamiliarity with SUMP as a diagnostic option. The initial adoption of a new reporting system will require a quality assessment to ensure that the system is reliable and useful for clinicians. Cancer Cytopathol 2018;126:390-6. © 2018 American Cancer Society.

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“…When blinded to the original institutional diagnosis and the clinical history, consensus review was consistent in one‐third of cases, resulted in a benign diagnosis in another one‐third, and was considered suspicious for malignancy in the remaining one‐third. In addition, 21% of 19 originally benign cases were categorized as AUS/FLUS . Preparation quality and inadequate cellular adequacy were cited as major factors influencing the lower concordance between pathologists for AUS/FLUS samples.…”

Section: Tissue Diagnosis and Managementmentioning

confidence: 99%

The incidental thyroid nodule

Fisher

Perrier

2018

CA A Cancer J Clinicians

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Incidental thyroid nodules that are found on an imaging study performed for reasons other than thyroid pathology represent a common scenario encountered by health care providers. The initial workup for these nodules comprises a thorough history and physical examination, thyroid function tests, a dedicated thyroid ultrasound, and fine-needle aspiration of any suspicious lesions. Management ranges from observation and reassurance to surgical resection and depends on the cytologic diagnosis. In cases of cytologically indeterminate or discordant nodules, surgical excision (lobectomy) offers a definitive diagnosis, although molecular testing or a reasonable period of observation may be useful as less invasive adjuncts. CA Cancer J Clin 2018;68:97-105. © 2018 American Cancer Society.

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Reproducibility of atypia of undetermined significance/follicular lesion of undetermined significance category using the bethesda system for reporting thyroid cytology when reviewing slides from different institutions: A study of interobserver variability among cytopathologists

Cited by 45 publications

References 34 publications

The Bethesda System for Reporting Thyroid Cytopathology: A Cytohistological Study

The Bethesda System for Reporting Thyroid Cytopathology: A Cytohistological Study

Northern Italy in the American South: Assessing interobserver reliability within the Milan System for Reporting Salivary Gland Cytopathology

The incidental thyroid nodule

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