480 chapter 12 Table 3. Test performance of combined diagnostic scenarios in nodules with successful MD on cytology a. All nodules (n=115) MD-/[18F]FDG- MD+/[18F]FDG+ Histopathology P value Test result Malignant Benign Malignant Benign Positive 29 56 22 20 Negative 1a 29 8 65 MD on cytology (n=115), assuming nodules under active surveillance are benign, % (95% CI) Sensitivity 97 (83-100) 73 (54-88) .02 Specificity 34 (24-45) 77 (66-85) <0.001 PPV 34 (24-45) 52 (36-68) NPV 97 (82-100) 89 (80-95) BCR 26 (18-35) 64 (54-72) b. non-oncocytic nodules, AUS+FN cytology (n=86) MD-/[18F]FDG- MD+/[18F]FDG+ A priori ROM 26% Histopathology P value Test result Malignant or borderline Benign Malignant or borderline Benign Positive 21 36 15 9 Negative 1d 28 7 55 MD on cytology (n=86), assuming nodules under active surveillance are benign, % (95% CI) Sensitivity 95 (77-100) 68 (45-86) .03 Specificity 44 (31-57) 86 (75-93) <0.001 PPV 37 (24-51) 63 (41-81) NPV 97 (82-100) 89 (78-95) BCR 34 (24-45) 72 (61-81) BCR, benign call rate; CI, confidence interval; [18F]FDG, 2-[18F]fluoro-2-deoxy-D-glucose; [18F]FDG-PET/CT, positron emission tomography/computed tomography using [18F]FDG; MD-/[18F]FDG-, a negative [18F]FDG-PET/CT and negative MD were considered a negative test result, all other combinations of [18F]FDG-PET/CT and MD results were considered test positive; MD+/[18F]FDG+, a positive [18F]FDG-PET/CT and positive MD were considered a positive test result, all other combinations of [18F]FDG-PET/CT and MD results were considered test negative; MD, molecular diagnostics; n, number; NPV, negative predictive value; PPV, positive predictive value. ROM, rate of malignancy, including borderline tumours. a: considering successful MD on cytology only, one MD-/[18F]FDG- malignancy was reported. In this nodule, an NTRK3 fusion was found during MD on histopathology.
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