Surgeon‐performed thyroid ultrasound—proving utility and credibility in selecting patients for fine needle aspiration according to the American thyroid association guidelines. A retrospective study of 500 patients

Cohen, Oded; Yarkoni, Tom Raz; Lahav, Yonatan; Azoulay, Ofer; Halperin, Doron; Yehuda, Moshe

doi:10.1111/coa.12984

Cited by 9 publications

(5 citation statements)

References 28 publications

(110 reference statements)

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“…Over the many years of the study period, patients were evaluated by surgeon performed preoperative US, which was proven to have good predictive abilities. In addition, it might be superior to community performed US 16 . This may also contribute to better patient selection, thus resulting in a higher rate of malignancy in the category.…”

Section: Discussionmentioning

confidence: 99%

Outcomes of the Bethesda system for reporting thyroid cytopathology: Real‐life experience

Avior

Dagan

Shochat

et al. 2020

Clinical Endocrinology

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Objective The 2017 revised Bethesda System for Reporting Thyroid Cytopathology (BSRTC) included new malignancy rates for each category as well as new management recommendations. Here, we evaluate the malignancy rate and test performance for BSRTC categories in a middle‐sized institution outside the United States (US). Design Retrospective single centre case series with chart review. Patients All patients who underwent thyroid surgery with a preoperative BSRTC between the years 2010 and 2018 at our institution. Measurements In order to assess the malignancy rate for each BSRTC, all medical records were reviewed to collect demographics, nodule's size, BSRTC and final pathology. Results Three hundred and sixty‐four patients were included, with an overall malignancy rate of 34.3%. The malignancy rate for BSRTC categories I‐VI was as follows: 13.3%, 5.1%, 25.0%, 24.4%, 91.3% and 95.2%, respectively. The most sensitive test was when BSRTC III‐VI were evaluated (91%). Overall best performance (sensitivity, specificity, PPV, NPV and accuracy) was obtained when BSRTC V‐VI were grouped together with a substantial decrease when adding BSRTC III‐IV (90%, 97%, 94%, 95%, 95% vs, respectively, 91%, 73%, 62%, 95%, 79%, respectively). Conclusions Despite differences from the reported 2017 BSRTC malignancy rates, we demonstrated that the revised 2017 BSRTC management recommendations for thyroid nodules are also valid in smaller non‐US centre, supporting its use globally.

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Section: Discussionmentioning

confidence: 99%

Outcomes of the Bethesda system for reporting thyroid cytopathology: Real‐life experience

Avior

Dagan

Shochat

et al. 2020

Clinical Endocrinology

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“…Moreover, in TT-PCND patients needing surgery for lymph node recurrent disease, the dissection the central compartment dissection can be avoided, thus decreasing the risks of RLN injury or parathyroid complications. On the other hand, different studies claim that there is no hard evidence to support the above statements (6,10,12,15,16).…”

Section: Discussionmentioning

confidence: 98%

“…Surgeon-performed US is increasing because of inadequate or incomplete imaging performed by radiologists (15). S-US has proven to be a reliable and consis-tent tool to assess the thyroid nodule risk stratification, thus surgeons should recognise the potential of this tool and its implementation (16).…”

Section: Discussionmentioning

confidence: 99%

Cervical Lymph Node Dissection for Papillary Thyroid Cancers: A Decade Experience of a Single Surgical Team

Simescu¹,

Sălceriu²,

Muntean³

2019

chr

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Premize: Pacienţii cu operaţii tiroidiene trebuie evaluaţi ecografic preoperator iar în cazul leziunilor suspecte puncţia aspirativă cu ac fin (FNA) trebuie să completeze investigaţiile. În ţările vestice, chirurgii endocrini efectuează de rutină ecografii cervicale. Rolul limfadenectomiei profilactice de compartiment central (LPCC) în cazul carcinoamelor papilare tiroidiene (CPT) rămâne controversat. În anul 2014 am efectuat o schimbare de strategie în tratamentul CPT: introducerea LPCC efectuată pe baza criteriilor European Society of Endocrine Surgeons (ESES) şi ecografia preoperatorie efectuată de către chirurg (S-US). Material şi Metodă: Pentru înţelegerea rolului jucat de cele două metode nou introduse am efectuat un studiu retrospectiv a două periode succesive de 5 ani, din baza noastră de date menţinută prospectiv. Rezultate: Cele două grupuri analizate au fost similare din punct de vedere epidemiologic şi clinic. FNA s-a efectuat la doar 21,66% dintre pacienţi. Diagnosticul de CPT a fost stabilit la majoritatea cazurilor prin examen histopatologic extemporaneu (EHE). S-US au ghidat limfadenectomia laterocervicală selectivă ducând astfel la îndepărtarea unui număr mai mare de ganglioni metastazaţi, având în plus şi o valoare predictivă pozitivă superioară celor efectuate de către endocrinologi. Rata de complicaţii a LPCC a fost semnificativ mai mare doar pe seama hipoparatiroidismului tranzitor.

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“…10 Experienced surgeon sonographers can also direct suspicious lesions for biopsy or even perform ultrasound-guided fine-needle aspiration (FNA) in the clinic with acceptable diagnostic yield and accuracy. 11,12 However, ultrasonography is notoriously user-dependent, and establishing a learning curve during residency is critical. Nondiagnostic or indeterminate results can lead to additional imaging, repetitive biopsy, or molecular profiling.…”

Section: Discussionmentioning

confidence: 99%

A Novel Thyroid Ultrasound Proficiency Metric Designed Through a Multidisciplinary Delphi Approach

Michaels

Khot

et al. 2021

The American Surgeon

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Background Thyroid ultrasounds extend surgeons’ outpatient capabilities and are essential for operative planning. However, most residents are not formally trained in thyroid ultrasound. The purpose of this study was to create a novel thyroid ultrasound proficiency metric through a collaborative Delphi approach. Methods Clinical faculty experienced in thyroid ultrasound participated on a Delphi panel to design the thyroid Ultrasound Proficiency Scale (UPS-Thyroid). Participants proposed items under the categories of Positioning, Technique, Image Capture, Measurement, and Interpretation. In subsequent rounds, participants voted to retain, revise, or exclude each item. The process continued until all items had greater than 70% consensus for retention. The UPS-Thyroid was pilot tested across 5 surgery residents with moderate ultrasound experience. Learning curves were assessed with cumulative sum. Results Three surgeons and 4 radiologists participated on the Delphi panel. Following 3 iterative Delphi rounds, the panel arrived at >70% consensus to retain 14 items without further revisions or additions. The metric included the following items on a 3-point scale for a maximum of 42 points: Positioning (1 item), Technique (4 items), Image Capture (2 items), Measurement (2 items), and Interpretation (5 items). A pilot group of 5 residents was scored against a proficiency threshold of 36 points. Learning curve inflection points were noted at between 4 to 7 repetitions. Conclusions A multidisciplinary Delphi approach generated consensus for a thyroid ultrasound proficiency metric (UPS-Thyroid). Among surgery residents with moderate ultrasound experience, basic proficiency at thyroid ultrasound is feasible within 10 repetitions.

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Surgeon‐performed thyroid ultrasound—proving utility and credibility in selecting patients for fine needle aspiration according to the American thyroid association guidelines. A retrospective study of 500 patients

Cited by 9 publications

References 28 publications

Outcomes of the Bethesda system for reporting thyroid cytopathology: Real‐life experience

Outcomes of the Bethesda system for reporting thyroid cytopathology: Real‐life experience

Cervical Lymph Node Dissection for Papillary Thyroid Cancers: A Decade Experience of a Single Surgical Team

A Novel Thyroid Ultrasound Proficiency Metric Designed Through a Multidisciplinary Delphi Approach

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