Digital image‐assisted quantitative nuclear analysis improves diagnostic accuracy of thyroid fine‐needle aspiration cytology

Background Thyroid fine‐needle aspiration (FNA) plays a key role in triaging thyroid nodules. Yet many cases are assigned to indeterminate categories. The new category “noninvasive follicular thyroid neoplasm with papillary‐like features” (NIFTP) complicates thyroid cytology. Digital image‐derived n...

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Bibliographic Details
Published in:Cancer cytopathology 2019-08, Vol.127 (8), p.501-513
Main Authors: Chain, Krista, Legesse, Teklu, Heath, Jonathon E., Staats, Paul N.
Format: Article
Language:English
Subjects:
Adenocarcinoma, Follicular - diagnosis
Adenocarcinoma, Follicular - pathology
Adenocarcinoma, Follicular - surgery
Biopsy, Fine-Needle - methods
Cell Nucleus - pathology
Cellular biology
cytology
digital image analysis
fine‐needle aspiration
Humans
Image Processing, Computer-Assisted
noninvasive follicular thyroid neoplasm with papillary‐like features (NIFTP)
papillary thyroid carcinoma
quantitative
Retrospective Studies
Software
thyroid
Thyroid cancer
Thyroid Cancer, Papillary - diagnosis
Thyroid Cancer, Papillary - pathology
Thyroid Cancer, Papillary - surgery
Thyroid gland
Thyroid Gland - cytology
Thyroid Gland - pathology
Thyroid Gland - surgery
Thyroid Neoplasms - diagnosis
Thyroid Neoplasms - pathology
Thyroid Neoplasms - surgery
Thyroid Nodule - diagnosis
Thyroid Nodule - pathology
Thyroid Nodule - surgery
Thyroidectomy
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Summary:Background Thyroid fine‐needle aspiration (FNA) plays a key role in triaging thyroid nodules. Yet many cases are assigned to indeterminate categories. The new category “noninvasive follicular thyroid neoplasm with papillary‐like features” (NIFTP) complicates thyroid cytology. Digital image‐derived nuclear measurements might objectively distinguish papillary thyroid carcinoma (PTC) from benign nodules and NIFTP. Methods All thyroid FNAs from 2012 to 2016 of atypia of undetermined significance (A; n = 8) and suspicious for malignancy (S; n = 2) with sufficient cellularity and surgical follow‐up, all FNAs preceding NIFTP (n = 6), and a random sample of PTC (n = 9) and benign (n = 10) cytology were studied. A modified Giemsa‐stained slide from each case was scanned using the Aperio imaging system, and long (dl) and short (ds)‐axis diameters were measured for 125 nuclei per case. Nuclear area and elongation were calculated. Results Nuclear area was larger in PTC (mean, 77.2 μm2 [range, 70.6‐86.0 μm2]) than benign (mean, 43.3 μm2 [range 38.2‐52.2 μm2]) (P 
ISSN:1934-662X
1934-6638
DOI:10.1002/cncy.22120