Educational exchange in thyroid core needle biopsy diagnosis: enhancing pathological interpretation through guideline integration and peer learning
1
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Background: While fine needle aspiration cytology (FNAC) plays an essential role in the screening of thyroid nodules, core needle biopsy (CNB) acts as an alternative method to address FNAC limitations. However, diagnosing thyroid CNB samples can be challenging due to variations in background and levels of experience. Effective training is indispensable to mitigate this challenge. We aim to evaluate the impact of an educational program on improving the accuracy of CNB diagnostics. Methods: The 2-week observational program included a host mentor pathologist with extensive experience and a visiting pathologist. The CNB classification by The Practice Guidelines Committee of the Korean Thyroid Association was used for the report. Two rounds of reviewing the case were carried out, and the level of agreement between the reviewers was analyzed. Results: The first-round assessment showed a concordance between two pathologists for 247 thyroid CNB specimens by 84.2%, with a kappa coefficient of 0.74 (indicating substantial agreement). This finding was attributed to the discordance in the use of categories III and V. After peer learning, the two pathologists evaluated 30 new cases, which showed an overall improvement in the level of agreement. The percentage of agreement between pathologists on thyroid CNB diagnosis was 86.7%, as measured by kappa coefficient of 0.80. Conclusions: This educational program, consisting of guided mentorship and peer learning, can substantially enhance the diagnostic accuracy of thyroid CNB. It is useful in promoting consistent diagnostic standards and contributes to the ongoing development of global pathology practices.
Abstract
Background: While fine needle aspiration cytology (FNAC) plays an essential role in the screening of thyroid nodules, core needle biopsy (CNB) acts as an alternative method to address FNAC limitations. However, diagnosing thyroid CNB samples can be challenging due to variations in background and levels of experience. Effective training is indispensable to mitigate this challenge. We aim to evaluate the impact of an educational program on improving the accuracy of CNB diagnostics. Methods: The 2-week observational program included a host mentor pathologist with extensive experience and a visiting pathologist. The CNB classification by The Practice Guidelines Committee of the Korean Thyroid Association was used for the report. Two rounds of reviewing the case were carried out, and the level of agreement between the reviewers was analyzed. Results: The first-round assessment showed a concordance between two pathologists for 247 thyroid CNB specimens by 84.2%, with a kappa coefficient of 0.74 (indicating substantial agreement). This finding was attributed to the discordance in the use of categories III and V. After peer learning, the two pathologists evaluated 30 new cases, which showed an overall improvement in the level of agreement. The percentage of agreement between pathologists on thyroid CNB diagnosis was 86.7%, as measured by kappa coefficient of 0.80. Conclusions: This educational program, consisting of guided mentorship and peer learning, can substantially enhance the diagnostic accuracy of thyroid CNB. It is useful in promoting consistent diagnostic standards and contributes to the ongoing development of global pathology practices.
참고문헌 (20)
- Kitahara CM, "Epidemiology of thyroid cancer", Cancer Epidemiol Biomarkers Prev, 31, pp.1284~1297 (2022)
- Lee EK, "A narrative review of the 2023Korean Thyroid Association management guideline for patients with thyroid nodules", Endocrinol Metab (Seoul), 39, pp.61~72 (2024)
- Haugen BR, "2015 American Thyroid Association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer : the American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer", Thyroid, 26, pp.1~133 (2016)
- Ali SZ, "The 2023 Bethesda System for Reporting Thyroid Cytopathology", Thyroid, 33, pp.1039~1044 (2023)
- Doubi A, "The value of repeating fine-needle aspiration for thyroid nodules", Ann Saudi Med, 41, pp.36~42 (2021)
- Suh CH, "Efficacy and safety of core-needle biopsy in initially detected thyroid nodules via propensity score analysis", Sci Rep, 7, pp.8242~ (2017)
- Kim HC, "First-line use of core needle biopsy for high-yield preliminary diagnosis of thyroid nodules", AJNR Am J Neuroradiol, 38, pp.357~363 (2017)
- Paja M, "Coreneedle biopsy in thyroid nodules : performance, accuracy, and complications", Eur Radiol, 29, pp.4889~4896 (2019)
- Jung CK, "2019 Practice guidelines for thyroid core needle biopsy : a report of the Clinical Practice Guidelines Development Committee of the Korean Thyroid Association", J Pathol Transl Med, 54, pp.64~86 (2020)
- Hahn SY, "Ultrasound-guided core needle biopsy techniques for intermediate or low suspicion thyroid nodules : which method is effective for diagnosis?", Korean J Radiol, 20, pp.1454~1461 (2019)
- Suh CH, "The role of core-needle biopsy in the diagnosis of thyroid malignancy in 4580 patients with 4746thyroid nodules : a systematic review and meta-analysis", Endocrine, 54, pp.315~328 (2016)
- Padmanabhan V, "Reproducibility of atypia of undetermined significance", follicular lesion of undetermined significance category using the bethesda system for reporting thyroid cytology when reviewing slides from different institutions : a study of interobserver variability among cytopathologists, 2017, pp.45, 399~405
- Clary KM, "Interobserver variability in the fine needle aspiration biopsy diagnosis of follicular lesions of the thyroid gland", Acta Cytol, 49, pp.378~382 (2005)
- Sripodok S, "Interobserver variability in inconclusive diagnostic categories of thyroid fine needle aspiration cytology : an urban-based tertiary hospital experience", Ann Diagn Pathol, 63, pp.152083~ (2023)
- Jung CK, "Reevaluating diagnostic categories and associated malignancy risks in thyroid core needle biopsy", J Pathol Transl Med, 57, pp.208~216 (2023)
- Elsheikh TM, "Interobserver and intraobserver variation among experts in the diagnosis of thyroid follicular lesions with borderline nuclear features of papillary carcinoma", Am J Clin Pathol, 130, pp.736~744 (2008)
- Seok JY, "Nuclear features of papillary thyroid carcinoma : comparison of core needle biopsy and thyroidectomy specimens", Ann Diagn Pathol, 32, pp.35~40 (2018)
- Haq F, "A matched-pair analysis of nuclear morphologic features between core needle biopsy and surgical specimen in thyroid tumors using a deep learning model", Endocr Pathol, 33, pp.472~483 (2022)
- Baloch ZW, "Overview of the 2022 WHO classification of thyroid neoplasms", Endocr Pathol, 33, pp.27~63 (2022)
- Jung CK, "Update from the 2022 World Health Organization classification of thyroid tumors : a standardized diagnostic approach", Endocrinol Metab (Seoul), 37, pp.703~718 (2022)
