Observational Study Assessing Current Practice in the Ultrasound U-Scoring of Thyroid Nodules Within a Tertiary Head and Neck Service
Phase 1 Study Assessing the Level of Agreement Between the US and Cytology
Colin P. Griffin, NHS University Hospitals of Liverpool Trust
Introduction:
The prevalence of focal thyroid disease is extremely high, up to 70% of the worldwide population. The diagnosis of focal thyroid pathology has exponentially increased over the past 25 years; however, the mortality rate has remained static for the past 50 years (Ganly et al., 2015). The diagnosis of thyroid disease depends on a combination of diagnostic elements, including ultrasound, radionuclide imaging, and pathological specimens from tissue sampling (Nasser, 2023).
Literature Review:
The literature shows the complexity and variability of systems for the diagnosis and management of thyroid disease. Due to this, many publications look at areas of correlation between varying imaging tests or between different tissue samples. There is a lack of publications regarding the decisionmaking process in ultrasound imaging and the impact such a process has on pathways, such as those required in thyroid cancer assessment.
Work to Date:
An observational study of current practice in a tertiary H&N centre was performed to review the level of concordance between ultrasound and fine needle aspiration cytology in thyroid nodules. The main aim of this study was to ensure that the radiology scoring of thyroid nodules is in keeping with the British Thyroid Association (BTA) standards (Perros et al., 2014) compared to the reference standard of the final cytopathological results in benign and indeterminate nodules. This showed poor correlation in this group and suggested that a deeper understanding of these findings was needed, leading to the development of future work.
Future Work:
The next stage of the project is to investigate reasons behind the decision-making processes and their possible cause of variations in clinicians’ ability to assess the ultrasound features of thyroid nodules and the factors that affect this decision-making process. The aim is to formulate a deeper understanding of clinical decision-making and to decide how biases can lead to interpretive or reporting errors.