Prevalence of cancer and the benign call rate of afirma gene classifier in 18F‐Fluorodeoxyglucose positron emission tomography positive cytologically indeterminate thyroid nodules
Abstract Background 18 F‐Fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) positive (PET+) cytologically indeterminate thyroid nodules (ITNs) have variable cancer risk in the literature. The benign call rate (BCR) of Afirma Gene Classifier (Gene Expression Classifier...
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| Format: | Article |
| Language: | English |
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Wiley
2021-02-01
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| Series: | Cancer Medicine |
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| Online Access: | https://doi.org/10.1002/cam4.3704 |
| _version_ | 1818410761863561216 |
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| author | Mayumi Endo Jennifer A. Sipos Matthew D. Ringel Kyle Porter Haikady N. Nagaraja John E. Phay Lawrence A. Shirley Clarine Long Chadwick L. Wright Katie Roll Fadi A. Nabhan |
| author_facet | Mayumi Endo Jennifer A. Sipos Matthew D. Ringel Kyle Porter Haikady N. Nagaraja John E. Phay Lawrence A. Shirley Clarine Long Chadwick L. Wright Katie Roll Fadi A. Nabhan |
| author_sort | Mayumi Endo |
| collection | DOAJ |
| description | Abstract Background 18 F‐Fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) positive (PET+) cytologically indeterminate thyroid nodules (ITNs) have variable cancer risk in the literature. The benign call rate (BCR) of Afirma Gene Classifier (Gene Expression Classifier, GEC, or Genome Sequence Classifier, GSC) in (PET +) ITNs is unknown. Methods This is a retrospective study at our institution of all patients with (PET+) ITNs (Bethesda III/IV) from 1 January 2010 to 21 May 2019 who underwent Afirma testing and/or surgery or repeat FNA with benign cytology. Results Forty‐five (PET+) ITNs were identified: 31 Afirma‐tested (GEC = 20, GSC = 11) and 14 either underwent surgery (n = 13) or repeat FNA (Benign cytology) (n = 1) without Afirma. The prevalence of cancer and noninvasive follicular thyroid neoplasm with papillary‐like nuclear features (NIFTP) including only resected nodules and ITN with repeat benign FNA (n = 33) was 36.4% (12/33). Excluding all Afirma “suspicious” non‐resected ITNs and assuming all Afirma “benign” ITNs were truly benign, that prevalence was 28.6% (12/42). The BCR with GSC was 64% compared to 25% with GEC (p = 0.056). Combining GSC/GEC‐tested ITNs, the BCR was higher in ITNs demonstrating low/very low‐risk sonographic pattern by the American Thyroid Association (ATA) classification and ITNs scoring <4 by the American College of Radiology Thyroid Imaging, Reporting and Data System (ACR‐TI‐RADS) than ITNs with higher sonographic pattern/score (p = 0.025). Conclusions The prevalence of cancer/NIFTP in (PET+) ITNs was 28.6–36.4% depending on the method of calculation. The BCR of Afirma GSC was 64%. Combining Afirma GEC/GSC‐tested ITNs, BCR was higher in ITNs with a lower risk sonographic pattern. |
| first_indexed | 2024-12-14T10:20:40Z |
| format | Article |
| id | doaj.art-494680436bc04eb78d57252000a7e31f |
| institution | Directory Open Access Journal |
| issn | 2045-7634 |
| language | English |
| last_indexed | 2024-12-14T10:20:40Z |
| publishDate | 2021-02-01 |
| publisher | Wiley |
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| series | Cancer Medicine |
| spelling | doaj.art-494680436bc04eb78d57252000a7e31f2022-12-21T23:06:37ZengWileyCancer Medicine2045-76342021-02-011031084109010.1002/cam4.3704Prevalence of cancer and the benign call rate of afirma gene classifier in 18F‐Fluorodeoxyglucose positron emission tomography positive cytologically indeterminate thyroid nodulesMayumi Endo0Jennifer A. Sipos1Matthew D. Ringel2Kyle Porter3Haikady N. Nagaraja4John E. Phay5Lawrence A. Shirley6Clarine Long7Chadwick L. Wright8Katie Roll9Fadi A. Nabhan10Division of Metabolism, Endocrinology, and Nutrition University of Washington Seattle WA USADivision of Endocrinology, Diabetes, and Metabolism The Ohio State University Wexner Medical Center and Arthur G. James Cancer Center Columbus Ohio USADivision of Endocrinology, Diabetes, and Metabolism The Ohio State University Wexner Medical Center and Arthur G. James Cancer Center Columbus Ohio USACenter for Biostatistics Department of Biomedical Informatics The Ohio State University Columbus Ohio USADivision of Biostatistics College of Public Health The Ohio State University Columbus USADepartment of Surgery The Ohio State University Comprehensive Cancer CenterThe Ohio State University Columbus Ohio USALexington Surgical Specialists Lexington KY USAThe Ohio State University College of Medicine Columbus OH USAWright Center of Innovation in Biomedical Imaging Division of Nuclear Medicine and Molecular Imaging Department of Radiology The Ohio State University Columbus Ohio USADivision of Endocrinology, Diabetes, and Metabolism The Ohio State University Wexner Medical Center and Arthur G. James Cancer Center Columbus Ohio USADivision of Endocrinology, Diabetes, and Metabolism The Ohio State University Wexner Medical Center and Arthur G. James Cancer Center Columbus Ohio USAAbstract Background 18 F‐Fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) positive (PET+) cytologically indeterminate thyroid nodules (ITNs) have variable cancer risk in the literature. The benign call rate (BCR) of Afirma Gene Classifier (Gene Expression Classifier, GEC, or Genome Sequence Classifier, GSC) in (PET +) ITNs is unknown. Methods This is a retrospective study at our institution of all patients with (PET+) ITNs (Bethesda III/IV) from 1 January 2010 to 21 May 2019 who underwent Afirma testing and/or surgery or repeat FNA with benign cytology. Results Forty‐five (PET+) ITNs were identified: 31 Afirma‐tested (GEC = 20, GSC = 11) and 14 either underwent surgery (n = 13) or repeat FNA (Benign cytology) (n = 1) without Afirma. The prevalence of cancer and noninvasive follicular thyroid neoplasm with papillary‐like nuclear features (NIFTP) including only resected nodules and ITN with repeat benign FNA (n = 33) was 36.4% (12/33). Excluding all Afirma “suspicious” non‐resected ITNs and assuming all Afirma “benign” ITNs were truly benign, that prevalence was 28.6% (12/42). The BCR with GSC was 64% compared to 25% with GEC (p = 0.056). Combining GSC/GEC‐tested ITNs, the BCR was higher in ITNs demonstrating low/very low‐risk sonographic pattern by the American Thyroid Association (ATA) classification and ITNs scoring <4 by the American College of Radiology Thyroid Imaging, Reporting and Data System (ACR‐TI‐RADS) than ITNs with higher sonographic pattern/score (p = 0.025). Conclusions The prevalence of cancer/NIFTP in (PET+) ITNs was 28.6–36.4% depending on the method of calculation. The BCR of Afirma GSC was 64%. Combining Afirma GEC/GSC‐tested ITNs, BCR was higher in ITNs with a lower risk sonographic pattern.https://doi.org/10.1002/cam4.370418Fluorine‐fluorodeoxyglucoseafirmapositron emission tomographyThyroid Nodules |
| spellingShingle | Mayumi Endo Jennifer A. Sipos Matthew D. Ringel Kyle Porter Haikady N. Nagaraja John E. Phay Lawrence A. Shirley Clarine Long Chadwick L. Wright Katie Roll Fadi A. Nabhan Prevalence of cancer and the benign call rate of afirma gene classifier in 18F‐Fluorodeoxyglucose positron emission tomography positive cytologically indeterminate thyroid nodules Cancer Medicine 18Fluorine‐fluorodeoxyglucose afirma positron emission tomography Thyroid Nodules |
| title | Prevalence of cancer and the benign call rate of afirma gene classifier in 18F‐Fluorodeoxyglucose positron emission tomography positive cytologically indeterminate thyroid nodules |
| title_full | Prevalence of cancer and the benign call rate of afirma gene classifier in 18F‐Fluorodeoxyglucose positron emission tomography positive cytologically indeterminate thyroid nodules |
| title_fullStr | Prevalence of cancer and the benign call rate of afirma gene classifier in 18F‐Fluorodeoxyglucose positron emission tomography positive cytologically indeterminate thyroid nodules |
| title_full_unstemmed | Prevalence of cancer and the benign call rate of afirma gene classifier in 18F‐Fluorodeoxyglucose positron emission tomography positive cytologically indeterminate thyroid nodules |
| title_short | Prevalence of cancer and the benign call rate of afirma gene classifier in 18F‐Fluorodeoxyglucose positron emission tomography positive cytologically indeterminate thyroid nodules |
| title_sort | prevalence of cancer and the benign call rate of afirma gene classifier in 18f fluorodeoxyglucose positron emission tomography positive cytologically indeterminate thyroid nodules |
| topic | 18Fluorine‐fluorodeoxyglucose afirma positron emission tomography Thyroid Nodules |
| url | https://doi.org/10.1002/cam4.3704 |
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