Endocrine Abstracts

Statement of the problem: Thyroid nodules are one of the most common clinical problems encountered today. Detection of these nodules have been augmented with ultrasonography and fine needle aspiration biopsy (FNAB). Worldwide, the use of international standards of reporting such as the American Thyroid Association (ATA) Sonographic Pattern Risk Assessment and the Bethesda System for Reporting Thyroid Cytopathology have been proven to detect thyroid malignancies. However, ultrasonographic descriptions and FNAB reports are different at the Ospital ng Makati (OSMAK), wherein these are described in ways that deviate from international standards. Thus, the study aimed to validate the association of these OSMAK-based reports with the histopathology results, and to determine their accuracy in detecting malignancy as confirmed by histopathology.

Methodology: A retrospective cohort study was utilized among patients 20 years old and above with thyroid malignancies who had thyroid ultrasonography and FNAB done at OSMAK between January 2012 and January 2017. Descriptive statistics were utilized to present the variables. Review of thyroid ultrasound descriptions and FNAB were done based on common descriptive findings seen on reports. The association between these findings and the histopathologic findings were done through Fisher’s Exact Test. The accuracy of these OSMAK-based descriptions and reports were then analyzed.

Findings: It was determined that there was not enough evidence to conclude that OSMAK-based thyroid ultrasonography was associated with histopathologic findings (P=0.135) and the test had an accuracy of detecting malignancy at 40.5%. Also, there was also not enough evidence to conclude that OSMAK-based FNAB was associated with histopathologic findings (P=0.083), and the test had an accuracy of 56.8%.

Conclusion & Significance: The use of OSMAK-based ultrasonography and FNAB reporting are not accurate in detecting thyroid malignancies. Hence, the use of validated, internationally-accepted guidelines should be implemented to help physicians provide the most appropriate care for these patients.