European experience with the Afirma Gene Expression Classifier for indeterminate thyroid nodules: A clinical utility study in the Netherlands

Abstract

Background

The Gene Expression Classifier (GEC) and Genomic Sequencing Classifier (GSC) were developed to improve risk stratification of indeterminate nodules. Our aim was to assess the clinical utility in a European population with restrictive diagnostic workup.

Methods

Clinical utility of the GEC was assessed in a prospective multicenter cohort of 68 indeterminate nodules. Diagnostic surgical rates for Bethesda III and IV nodules were compared to a historical cohort of 171 indeterminate nodules. Samples were post hoc tested with the GSC.

Results

The GEC classified 26% as benign. Surgical rates between the prospective and historical cohort did not differ (72.1% vs. 76.6%). The GSC classified 59% as benign, but misclassified six malignant lesions as benign.

Conclusion

Implementation of GEC in management of indeterminate nodules in a European country with restrictive diagnostic workup is currently not supported, especially in oncocytic nodules. Prospective studies with the GSC in European countries are needed to determine the clinical utility.

Overview publication

TitleEuropean experience with the Afirma Gene Expression Classifier for indeterminate thyroid nodules: A clinical utility study in the Netherlands
DateSeptember 1st, 2023
Issue nameHead & Neck
Issue numberv45.9 p2227-2236
DOI10.1002/hed.27472
AuthorsLončar I, van Velsen EFS, Massolt ET, van Kemenade FJ, van Engen‐van Grunsven ACH, van Hemel BM, van Nederveen FH, Netea‐Maier R, Links TP, Peeters RP & van Ginhoven TM
MTGsMTG8
Read Read publication