{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T20:46:27Z","timestamp":1792183587357,"version":"4.4.0"},"reference-count":48,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2020,8,7]],"date-time":"2020-08-07T00:00:00Z","timestamp":1596758400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100010413","name":"Interpace Diagnostics","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100010413","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diagnostic Cytopathology"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Approximately 25% of thyroid nodule fine\u2010needle aspirates (FNAs) have cytology that is indeterminate for malignant disease. Accurate risk stratification of these FNAs with ancillary testing would reduce unnecessary thyroid surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We evaluated the performance of an ancillary multiplatform test (MPTX) that has three diagnostic categories (negative, moderate, and positive). MPTX includes the combination of a mutation panel (ThyGeNEXT\u00ae) and a microRNA risk classifier (ThyraMIR\u00ae). A blinded, multicenter study was performed using consensus histopathology diagnosis among three pathologists to validate test performance.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Unanimous consensus diagnosis was reached in 197 subjects with indeterminate thyroid nodules; 36% had disease. MPTX had 95% sensitivity (95% CI,86%\u201099%) and 90% specificity (95% CI,84%\u201095%) for disease in prevalence adjusted nodules with Bethesda III and IV cytology. Negative MPTX results ruledout disease with 97% negative predictive value (NPV; 95% CI,91%\u201099%) at a 30% disease prevalence, while positive MPTX results ruledin high risk disease with 75% positive predictive value (PPV; 95% CI,60%\u201086%). Such results are expected in four out of five Bethesda III and IV nodules tested, including <jats:italic>RAS<\/jats:italic> positive nodules in which the microRNA classifier was useful in rulingin disease. 90% of mutation panel false positives were due to analytically verified <jats:italic>RAS<\/jats:italic> mutations detected in benign adenomas. Moderate MPTX results had a moderate rate of disease (39%, 95% CI,23%\u201054%), primarily due to <jats:italic>RAS<\/jats:italic> mutations, wherein the possibility of disease could not be excluded.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our results emphasize that decisions for surgery should not solely be based on <jats:italic>RAS<\/jats:italic> or <jats:italic>RAS<\/jats:italic>\u2010like mutations. MPTX informs management decisions while accounting for these challenges.<\/jats:p><\/jats:sec>","DOI":"10.1002\/dc.24564","type":"journal-article","created":{"date-parts":[[2020,8,8]],"date-time":"2020-08-08T01:48:25Z","timestamp":1596851305000},"page":"1254-1264","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":108,"title":["Multiplatform molecular test performance in indeterminate thyroid nodules"],"prefix":"10.1002","volume":"48","author":[{"given":"Mark A.","family":"Lupo","sequence":"first","affiliation":[{"name":"Thyroid &amp; Endocrine Center of Florida  Sarasota Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ann E.","family":"Walts","sequence":"additional","affiliation":[{"name":"Cedars\u2010Sinai Medical Center  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. 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