Arnie Charbonneau Cancer Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
Eur Thyroid J. 2023 Aug 11;12(5):e230110. doi: 10.1530/ETJ-23-0110.
The aim of this study was to prospectively evaluate the quality of postoperative neck ultrasound (POU) for thyroid cancer patients after implementing European Thyroid Association (ETA) guideline-based POU assessment.
Our analysis involved 672 differentiated thyroid cancer patients. POU report quality was compared between the implementation radiology group (IRG), which implemented ETA guideline-based assessment in 2018, and all non-implementation radiology groups (NIRG). Differences in POU quality were evaluated before and after the implementation of guideline-based assessment. Additionally, we evaluated the ability of serum thyroglobulin (Tg) level <0.2 ng/mL or between 0.21 and 0.99 ng/mL and normal POU lesion status at 1-year follow-up to predict the absence of persistent disease or relapse at 3-year follow-up.
IRG had significantly higher mean utility scores for POU reports of abnormal thyroid bed nodules compared to NIRG (P < 0.001). IRG's POU reports for suspicious nodules and lymph nodes were considered sufficient in 94% and 85% of cases, respectively, compared to 45% and 68% for NIRG. For patients with normal US lesion status and Tg <0.2 ng/mL or Tg 0.21-0.99 ng/mL at 1-year follow-up, the negative predictive values were 96% for both.
Implementation of 2013 ETA POU-reporting guidelines allowed for the provision of high-quality POU reports, which may lead to increased accuracy in assessing the response to treatment and in estimating the risk of recurrence of thyroid cancer and likely reduce unnecessary repeat POU or FNA.
本研究旨在前瞻性评估实施欧洲甲状腺协会（ETA）基于指南的颈部超声（POU）评估后甲状腺癌患者的术后 POU 质量。
我们的分析涉及 672 例分化型甲状腺癌患者。比较了 2018 年实施 ETA 指南评估的放射科实施组（IRG）和所有非放射科实施组（NIRG）之间的 POU 报告质量。在实施指南评估前后评估了 POU 质量的差异。此外，我们评估了血清甲状腺球蛋白（Tg）水平<0.2ng/mL 或 0.21-0.99ng/mL 以及 1 年随访时正常 POU 病变状态对预测 3 年随访时无持续性疾病或复发的能力。
与 NIRG 相比，IRG 对异常甲状腺床结节的 POU 报告具有显著更高的平均效用评分（P<0.001）。与 NIRG 相比，IRG 对可疑结节和淋巴结的 POU 报告分别有 94%和 85%被认为是充分的，而 NIRG 分别为 45%和 68%。对于 1 年随访时 US 病变状态正常且 Tg<0.2ng/mL 或 Tg 0.21-0.99ng/mL 的患者，两者的阴性预测值均为 96%。
实施 2013 年 ETA POU 报告指南允许提供高质量的 POU 报告，这可能导致治疗反应评估的准确性提高，并估计甲状腺癌复发的风险，可能减少不必要的重复 POU 或 FNA。
