FDG-PET/CT in indeterminate thyroid nodules: cost-utility analysis alongside a randomised controlled trial.

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Abstract

To evaluate cost-effectiveness of an [18F]FDG-PET/CT-driven diagnostic workup as compared to diagnostic surgery, for thyroid nodules with Bethesda III/IV cytology. [18F]FDG-PET/CT avoids 40% of futile diagnostic surgeries for benign Bethesda III/IV nodules.

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Most cited references 66

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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.

Bryan Haugen, Erik Alexander, Keith Bible … (2016)

Thyroid nodules are a common clinical problem, and differentiated thyroid cancer is becoming increasingly prevalent. Since the American Thyroid Association's (ATA's) guidelines for the management of these disorders were revised in 2009, significant scientific advances have occurred in the field. The aim of these guidelines is to inform clinicians, patients, researchers, and health policy makers on published evidence relating to the diagnosis and management of thyroid nodules and differentiated thyroid cancer.

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Development and preliminary testing of the new five-level version of EQ-5D (EQ-5D-5L)

M. Herdman, C. Gudex, S Lloyd … (2011)

Purpose This article introduces the new 5-level EQ-5D (EQ-5D-5L) health status measure. Methods EQ-5D currently measures health using three levels of severity in five dimensions. A EuroQol Group task force was established to find ways of improving the instrument’s sensitivity and reducing ceiling effects by increasing the number of severity levels. The study was performed in the United Kingdom and Spain. Severity labels for 5 levels in each dimension were identified using response scaling. Focus groups were used to investigate the face and content validity of the new versions, including hypothetical health states generated from those versions. Results Selecting labels at approximately the 25th, 50th, and 75th centiles produced two alternative 5-level versions. Focus group work showed a slight preference for the wording ‘slight-moderate-severe’ problems, with anchors of ‘no problems’ and ‘unable to do’ in the EQ-5D functional dimensions. Similar wording was used in the Pain/Discomfort and Anxiety/Depression dimensions. Hypothetical health states were well understood though participants stressed the need for the internal coherence of health states. Conclusions A 5-level version of the EQ-5D has been developed by the EuroQol Group. Further testing is required to determine whether the new version improves sensitivity and reduces ceiling effects.

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The 2017 Bethesda System for Reporting Thyroid Cytopathology.

Syed Z. Ali, Edmund S Cibas (2017)

The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) established a standardized, category-based reporting system for thyroid fine-needle aspiration (FNA) specimens. The 2017 revision reaffirms that every thyroid FNA report should begin with one of six diagnostic categories, the names of which remain unchanged since they were first introduced: (i) nondiagnostic or unsatisfactory; (ii) benign; (iii) atypia of undetermined significance (AUS) or follicular lesion of undetermined significance (FLUS); (iv) follicular neoplasm or suspicious for a follicular neoplasm; (v) suspicious for malignancy; and (vi) malignant. There is a choice of two different names for some of the categories. A laboratory should choose the one it prefers and use it exclusively for that category. Synonymous terms (e.g., AUS and FLUS) should not be used to denote two distinct interpretations. Each category has an implied cancer risk that ranges from 0% to 3% for the "benign" category to virtually 100% for the "malignant" category, and, in the 2017 revision, the malignancy risks have been updated based on new (post 2010) data. As a function of their risk associations, each category is linked to updated, evidence-based clinical management recommendations. The recent reclassification of some thyroid neoplasms as noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) has implications for the risk of malignancy, and this is accounted for with regard to diagnostic criteria and optional notes. Such notes can be useful in helping guide surgical management.

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Author and article information

Journal

Journal ID (iso-abbrev): Eur J Nucl Med Mol Imaging

Title: European journal of nuclear medicine and molecular imaging

Publisher: Springer Science and Business Media LLC

ISSN (Electronic): 1619-7089

ISSN (Print): 1619-7070

Publication date (Electronic): August 2022

Volume: 49

Issue: 10

Affiliations

[1 ] Department of Radiology and Nuclear Medicine, Radboud University Medical Centre, Nijmegen, the Netherlands. Lisanne.deKoster@radboudumc.nl.

[2 ] Department of Radiology, Section of Nuclear Medicine, Leiden University Medical Center, Leiden, the Netherlands.

[3 ] Department of Internal Medicine, Haga Hospital, The Hague, the Netherlands.

[4 ] Department of Internal Medicine, Meander Medical Centre, Amersfoort, the Netherlands.

[5 ] Department of Radiology and Nuclear Medicine, Radboud University Medical Centre, Nijmegen, the Netherlands.

[6 ] Department of Radiology and Nuclear Medicine, Rijnstate Hospital, Arnhem, the Netherlands.

[7 ] Department of Biomedical Sciences and Humanitas Clinical and Research Centre, Department of Nuclear Medicine, Humanitas University, Milan, Italy.

[8 ] Department of Internal Medicine, Erasmus University Medical Centre, Rotterdam, the Netherlands.

[9 ] Department of Surgery, Leiden University Medical Center, Leiden, the Netherlands.

[10 ] Biomedical Photonic Imaging Group, University of Twente, Enschede, the Netherlands.

[11 ] Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, the Netherlands.

Article

Publisher Item ID: 10.1007/s00259-022-05794-w

DOI: 10.1007/s00259-022-05794-w

PMC ID: 9308600

PubMed ID: 35435497

SO-VID: a0203d0d-9eb8-4f6f-aa10-52e420da520b

History

Keywords: Cost-effectiveness,Costs,Health-related quality of life,Indeterminate thyroid nodule,QALY,Thyroid carcinoma,Thyroid surgery,[18F]FDG-PET/CT

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Keywords: Cost-effectiveness, Costs, Health-related quality of life, Indeterminate thyroid nodule, QALY, Thyroid carcinoma, Thyroid surgery, [18F]FDG-PET/CT

FDG-PET/CT in indeterminate thyroid nodules: cost-utility analysis alongside a randomised controlled trial.

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Most cited references 66

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.

Development and preliminary testing of the new five-level version of EQ-5D (EQ-5D-5L)

The 2017 Bethesda System for Reporting Thyroid Cytopathology.

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