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A Unique Approach to Assessing the Risk of Indeterminate Thyroid Nodules

A Unique Approach to Assessing the Risk of Indeterminate Thyroid Nodules

Format

Webcast

Time to Complete

45 minutes

Released

October 10, 2019

Expires

October 10, 2020
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Maximum Credits

0.75 / AMA PRA Category 1 Credit(s)TM

Accredited Provider


Provided by Haymarket Medical Education

Commercial Supporter

Supported by an educational grant from Interpace Diagnostics

Program Description

When managing thyroid nodules, physicians need to distinguish potentially malignant nodules from those with benign disease to limit unnecessary surgery. Fine-needle aspiration (FNA) can identify 80% of malignant nodules and 70% of benign nodules without having to perform diagnostic surgery, thus decreasing the need for surgery in patients with a low probability of cancer. However, the relatively low diagnostic yield of cytology results in up to 20% of nodule aspirates of indeterminate malignant risk.

Because the clinician and surgeon may be unable to determine malignancy preoperatively or intra-operatively, patients with indeterminate thyroid lesions on FNA cannot be optimally managed. Molecular markers help inform the malignant potential of thyroid nodules and thus serve as an important adjunct to FNA cytology. In this CME-certified activity, Dr. Nicole A. Massoll, Professor of Pathology and Director of Cytopathology at the University of Arkansas for Medical Sciences in Little Rock, discusses the role of microRNAs as biomarkers, illustrates how molecular testing can guide clinicians to make the most appropriate treatment recommendations for their patients, and reviews the sensitivity and specificity of commercially available molecular tests for indeterminate thyroid nodules.

Intended Audience

Endocrinologists, Pathologists, Surgeons, and other clinicians who manage patients at potential risk for thyroid carcinoma

Educational Objectives

At the conclusion of this activity, participants should be better able to:

  • Discuss the revised 2017 Bethesda System for Reporting Thyroid Cytopathology guidelines and their impact on classification, cytological analysis, and malignancy risk
  • Identify the role of microRNAs as biomarkers
  • Illustrate how molecular testing can guide clinicians to make the most appropriate treatment recommendations for their patients
  • Analyze how cancer prevalence impacts the negative predictive value (NPV) and positive predictive value (PPV) for molecular tests
  • Evaluate the role of microRNA classification and how it may complement cytology and mutation analysis to better differentiate thyroid nodules at high risk of malignancy
  • Provide guidance for cytologically indeterminate thyroid nodules and the risk of thyroid cancer in subsets of patients with weak driver mutations

Conflict Of Interest Disclosure Policies

In accordance with the ACCME Standards for Commercial Support, HME requires that individuals in a position to control the content of an educational activity disclose all relevant financial relationships with any commercial interest. HME resolves all conflicts of interest to ensure independence, objectivity, balance, and scientific rigor in all its educational activities.

Faculty

Nicole A. Massoll, MD
Professor of Pathology and Director of Cytopathology
University of Arkansas for Medical Sciences
Little Rock, AR

Dr. Massoll is a consultant for Interpace Diagnostics and xMD Diagnostics, Inc.

Independent Peer Reviewer

Ruchit Parikh, PharmD

Dr. Parikh
has nothing to disclose

Accredited Provider Disclosures

Haymarket Medical Education staff involved in the planning and content review of this activity have no relevant financial relationships to disclose.

Credit

0.75

Type

AMA PRA Category 1 Credit(s)TM

Accreditation Statement

Haymarket Medical Education is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Designation Statement

Haymarket Medical Education designates this enduring material for a maximum of 0.75 AMA PRA Category 1 Credit(s)TM .  Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Additional Credit Information

Physician Assistant Continuing Education
AAPA accepts certificates of participation for educational activities approved for AMA PRA Category 1 CreditTM   from organizations accredited by ACCME or a recognized state medical society. PAs may receive a maximum of 0.75 Category 1 Credit for completing this activity.

Nurse Practitioner Continuing Education
AANPCP accepts certificates of participation for educational activities approved for AMA PRA Category 1 CreditTM   from organizations accredited by ACCME. Individuals are responsible for checking with the AANPCP for further guidelines.

Disclosure of Unlabeled Use

This CME activity may or may not discuss investigational, unapproved, or off-label use of drugs. Participants are advised to consult prescribing information for any products discussed. The information provided in this CME activity is for continuing medical education purposes only and is not meant to substitute for the independent medical judgment of a physician relative to diagnostic and treatment options for a specific patient's medical condition.

Disclaimer

The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of Haymarket Medical Education or Interpace Diagnostics. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.

If you have any questions relating to the accreditation of this activity, please contact Julie.Tagliareni julie.tagliareni@haymarketmedical.com

Instructions

To obtain credit, a score of 70% or better on the post-test is required. This activity is offered at no cost to participants. Please proceed with the activity until you have successfully completed this program, answered all test questions, completed the post-test and evaluation, and have received a digital copy of your credit certificate. Your online certificate will be saved on myCME within your Profile/CME History, which you can access at any time.

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  • Additional Software: Adobe Flash Player and/or an HTML 5 capable browser maybe required for video or audio playback. PowerPoint or Adobe Acrobat Reader may occasionally be required
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