EP140 – Has the introduction of the U Classification changed the management of thyroid nodules?

      Bondin, Daniela1; Morar, Pradeep2; Belloso, Antonio2 1 St7 Otorhinolaryngologist, East Lancashire Health Trust, UK 2 Consultant Otorhinolaryngologist, East Lancashire Health Trust, UK   Background: The 2014 BAETS guidelines for assessment of thyroid nodules introduced the use of U classification in combination with the Thy classification to increase the positive predictive pre-operative value for detection of thyroid cancer. This aim of the project was to assess the impact of these recommendations in the management of thyroid nodules. Methods: This was a retrospective evaluation of patients referred to the neck lump at East Lancashire Health Trust between 1st January 2015 and 31st December 2015. Results: Total Number of referrals was 116 patients. Males: 17: Females: 99. The mean age: 49.5 (Variation between15 – 86) U Classification The total number of reported USS performed was : 91/115 (79%). 73.75% of all USS performed by the dedicated radiologist were reported using the U classification. 61% of U2 patients were discharged with no FNA or further surgical intervention.
    U CLASSIFICATION Total Number % Of malignancy
    U2 61 3.3%
    U3 26 19%
    U4 2 100%
    U5 2 100%
    Discussion / Conclusion: The use of the U classification and its role in adequately diagnosing thyroid cancer is still currently under review. There is a recognised learning curve for this classification to be utilised in practice and its difficult to ascertain whether discharging patients on the basis of using the U classification alone for U2 nodules is safe.   References:
    1. Perros P, Colley S, Boelaert K, Evans C, Evans RM, Gerrard GE, Gilbert JA et al. Guidelines for the management of thyroid cancer. Clinical Endocrinology July 2014;81(s1).

 

Leave a Reply