Diagnostic value and cost‐effectiveness of FNA‐CT versus fine-needle aspiration cytology (FNAC) for medullary thyroid carcinoma
Authors' conclusion
FNA-CT can serve as an auxiliary and cost-effective approach for patients with indeterminate sCT levels to detect occult MTC lesions. FNA-CT can be recommended for patients with sCT >100 pg/ml to overcome the high false-negative rate of FNAC.
Study context
- Population
- Patients with thyroid nodules screened for serum calcitonin (sCT) at three medical centres, January 2020–May 2022; group 1: 10 pg/ml< sCT ≤100 pg/ml; group 2: sCT > 100 pg/ml27,404 screened
- Participants
- 223 patients
- Comparison
- FNA-CT vs FNAC for diagnosing medullary thyroid carcinoma (MTC)
- Outcome
- Diagnostic performance (sensitivity, NPV, overall accuracy) and cost-effectiveness for MTC
Methodological detailsmulticentre, cost-effectiveness analysis, decision tree model
- Multicentre
- Cost-effectiveness analysis
- Decision tree model
Performance
As reported in the abstract
Diagnostic performance for MTC, group 1 (10 pg/ml< sCT ≤100 pg/ml; 24 MTC, 167 non-MTC nodules)
| Test or model | Sensitivity | NPV | Overall accuracy |
|---|---|---|---|
| FNA-CT | 100.0% | 100.0% | 100.0% |
| FNAC | 58.3% | 94.3% | 94.7% |
Sensitivity
FNA-CT100.0%
FNAC58.3%
NPV
FNA-CT100.0%
FNAC94.3%
Overall accuracy
FNA-CT100.0%
FNAC94.7%
Further findings
Diagnostic performance for MTC, group 2 (sCT > 100 pg/ml; 67 MTC, 7 non-MTC nodules)
Sensitivity
NPV
Overall accuracy
Cost-effectiveness
- Decision tree model: FNA-CT was a cost-effective tool for diagnosing MTC
Normal sCT among patients with thyroid nodules
- Normal sCT levels
- N = 25,228; 92.1%
Original publication
Diagnostic value and cost‐effectiveness of FNA‐CT versus FNAC for medullary thyroid carcinoma. Clin Endocrinol (Oxf). Published 23 November 2022. doi:10.
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