Outcomes of Cytologically Indeterminate Thyroid Nodules Managed With Genomic Sequencing Classifier
Authors' conclusion
GSC is a key tool for managing patients with indeterminate cytology, including the higher-risk Bethesda IV category. GSC-benign thyroid nodules can be observed similarly to thyroid nodules with benign cytology.
Study context
- Population
- Adults with cytologically indeterminate (Bethesda III or IV) thyroid nodules biopsied at 3 major academic centers, July 2017–June 2021, managed with Afirma genomic sequencing classifier (GSC); surgery or ≥1 year US surveillance
- Participants
- 834 indeterminate nodules
- Comparison
- Bethesda III vs Bethesda IV
- Outcome
- Sensitivity, specificity, PPV and NPV of GSC in Bethesda III and IV nodules
Methodological detailsmulticentre
- Multicentre
Performance
As reported in the abstract
GSC diagnostic performance across all institutions
| Test or model | Sensitivity | Specificity | PPV | NPV |
|---|---|---|---|---|
| Bethesda III | 95% | 81% | 50% | 99% |
| Bethesda IV | 94% | 82% | 65% | 98% |
Sensitivity
Bethesda III95%
Bethesda IV94%
Specificity
Bethesda III81%
Bethesda IV82%
PPV
Bethesda III50%
Bethesda IV65%
NPV
Bethesda III99%
Bethesda IV98%
Further findings
GSC performance in nodules with oncocytic predominance
NPV
PPV
Overall false-negative rate
- Overall false-negative rate
- 2%
Growth of GSC-benign nodules during surveillance · median follow-up 23 months
- GSC-benign nodules that grew during surveillance
- 22%
Original publication
Outcomes of Cytologically Indeterminate Thyroid Nodules Managed With Genomic Sequencing Classifier. J Clin Endocrinol Metab. Published 28 February 2024. doi:10.
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