1.Agreement between sonographic features and fine needle aspiration cytology in the diagnosis of thyroid nodules in a Tertiary Hospital
Danette Pabalan ; Ricardo Victorio Quimbo
Philippine Journal of Pathology 2024;9(1):38-41
Objective:
Management of thyroid nodules relies on the Thyroid Imaging Recording and Data System (TIRADS) for sonographic findings and the Bethesda System for Reporting Thyroid Cytopathology (TBSRTC). The proponents aimed to determine the concordance between sonographic TIRADS findings and cytological diagnosis by TBSRTC in the evaluation of malignancy of patients with thyroid nodules.
Methodology:
Sonographic and cytology results collected from 2018 to 2022 were obtained to determine whether there is an agreement between TIRADS and TBSRTC findings.
Results:
Two hundred sixty-two (262) samples were obtained. Overall accuracy of predicting TIRADS category was highest for echogenic foci. Thyroid nodule distribution was highest for TIRADS 3 and 4 sonographically and TBSRTC II cytologically. There is low agreement between TBSRTC and TIRADS in the categorization of nodules as benign, implying that nodules may show sonographic features suspicious of malignancy despite being categorized as TBSRTC I or II by cytology. However, nodules categorized as TBSRTC III to VI show sonographic features suspicious for malignancy at the very least.
Conclusion
The correctness of TIRADS prediction is highest for echogenic foci although not significantly higher than other parameters. The overall predicting power of TIRADS for the absence of malignancy is high for TIRADS 1 and 2, whereas TIRADS 5 predicts a 31.11% risk of malignancy making it a strong indication for FNAC. However, prediction of malignancy in TIRADS 3 and 4 nodules must be in association with other factors since a significant percentage may turn out to be TBSRTC II.
Thyroid Nodule
2.Evaluation of Rapid Antigen Testing (Panbio™ COVID-19 Ag Rapid Test Device) for COVID-19 diagnosis in a Tertiary Hospital
Danette Pabalan ; Pamela Delos Reyes-Murillo
Philippine Journal of Pathology 2024;9(1):22-26
Background:
The Panbio™ COVID-19 Ag Rapid Test is a Food and Drug Administration (FDA)-approved point-of-care test (POCT) used for SARS-CoV-2 detection which has met minimum sensitivity and specificity requirements by the World Health Organization (WHO).
Objective:
The study aimed to compare the clinical performance of a commercial lateral flow assay (LFA) to reverse transcriptase polymerase reaction (RT-PCR) in SARS-CoV-2 infection diagnosis
Methodology:
Clinical data and simultaneous LFA and RT-PCR samples collected from June 2021 to June 2022 were obtained to analyze the diagnostic accuracy of LFA compared to RT-PCR.
Results:
A total of 265 samples was obtained. 34.45% of RT-PCR positive samples were reliably detected by LFA. COVID-19 was reliably ruled out by LFA in 99.32% RT-PCR negative samples. LFA sensitivity among symptomatic patients with ≤7 days of illness was 51.61%, slightly higher than those with >7 days of illness (18.92%), and significantly higher than asymptomatic patients (16.67%). Asymptomatic subjects have a varied range of Ct-values, indicating different stages of infection or viral loads. Individuals with symptoms for more than 7 days have higher Ct-values, suggesting they are in later stages of infection or have lower viral loads. The probability of a positive LFA result decreases significantly when the Ct-value is beyond 28-30.
Conclusion
The LFA evaluated in this study did not show significant sensitivity and specificity during the early disease course wherein viral loads are suggestively high. However, its utility to accurately rule out COVID-19 is quite reliable in subjects with symptoms that are >7 days since Ct-values are suggestively beyond 28-30 which implies a significantly decreased probability of a positive LFA result.
COVID-19
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SARS-CoV-2