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Published in: Indian Journal of Otolaryngology and Head & Neck Surgery 2/2022

07-01-2021 | Hemithyroidectomy | Original Article

Usefulness of The Bethesda System of Reporting Thyroid Cytopathology in Surgical Planning

Authors: Swetal Mahajan, B. V. Manjula, R. Vaishnavi, Neena John, Bhuvaneshwari Babu

Published in: Indian Journal of Otolaryngology and Head & Neck Surgery | Special Issue 2/2022

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Abstract

The Bethesda system for reporting thyroid cytopathology (TBSRTC) has attempted to standardize thyroid fine needle aspiration cytology (FNAC) reporting internationally into six diagnostic categories and help in clinical decision making. But there exists a significant variation in the reporting percentage and rates of malignancies in each category across the centres which complicates clinical decision making. To study the usefulness of TBSRTC in surgical planning of thyroid nodules and to correlate TBSRTC with final histopathology. 85 patients with thyroid nodules who underwent surgery were evaluated prospectively. Preoperatively FNAC and TBSRTC reporting was done and following surgery histopathology was correlated with cytology. Distribution of 85 patients amongst the six categories of TBSRTC was as follows: 2.35% in Category I, 68.23% II, 7.05% III, 16.47% IV, 2.35% V and 3.52% VI. In 93% (79) of patients TBSRTC correlated with histopathology whereas in 7% (6) it did not. Risk of malignancy calculated was 0% in II, 33.33% in III, 7.14% in IV and 100% in V and VI categories. Sensitivity, specificity, Positive Predictive Value and Negative Predictive Value of TBSRTC was 100% for V, VI categories, whereas it was 100%, 78%, 15% and 100% respectively for III, IV. The diagnostic accuracy in our study is 100% for Category V and VI whereas it is 79% for Category III and IV. TBSRTC proved to be a very good screening platform for triaging patients with thyroid nodules into benign and malignant groups, as it is directly related to risk of malignancy in each category. It has helped in appropriate surgical planning in 96.4% of our patients.
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Metadata
Title
Usefulness of The Bethesda System of Reporting Thyroid Cytopathology in Surgical Planning
Authors
Swetal Mahajan
B. V. Manjula
R. Vaishnavi
Neena John
Bhuvaneshwari Babu
Publication date
07-01-2021
Publisher
Springer India
Published in
Indian Journal of Otolaryngology and Head & Neck Surgery / Issue Special Issue 2/2022
Print ISSN: 2231-3796
Electronic ISSN: 0973-7707
DOI
https://doi.org/10.1007/s12070-020-02335-5

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