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Verma T, et al. The role of the ThyGeNEXT oncogene panel used in combination with the expanded miRNA panel ThyraMIRv2 in Indeterminate thyroid nodules: A large, blinded, real-world, observational study. Cancer Cytopathol. Published online May 30, 2024. doi:10.1002/cncy.22829.

This large, blinded, real-world, observational study was conducted by the Allegheny Health Network. There were 338 samples with either an Atypia of Undetermined Significance (Bethesda III) or a Follicular Neoplasm (Bethesda IV) cytology diagnosis. Of the 338 samples, 90 cases had confirmed surgical outcomes, and the remaining 248 patients were undergoing surveillance and all patients in this group received at least one follow-up ultrasound which documents no change in size or features.

All samples originally underwent testing with ThyGeNEXT® + ThyraMIR® as part of the standard work-up for cases with a Bethesda III or Bethesda IV cytology diagnosis. ThyGeNEXT is an oncogene panel which includes the mutations most commonly found in all types of thyroid cancer. ThyraMIR is a microRNA (miRNA) algorithmic risk classifier. This unique combination test platform is abbreviated at MPTXv1 (multi-platform testing – version 1). These samples were later tested using ThyGeNEXT along with a new optimized version of the microRNA test known as ThyraMIR®v2. ThyraMIRv2 includes both the algorithmic risk classifier as well as pairwise miRNA expression profiling. This added microRNA analysis has been shown to further risk stratify indeterminate thyroid nodules (ITN).

MPTXv2 showed a statistically greater area under the curve (p=.028) than MPTXv1, demonstrating greater accuracy for MPTXv2.

Notably, MPTXv2 improved the reporting accuracy of nonmutated as well as mutated nodules. There were four samples reported as moderate by MPTXv1. These same samples were reported as positive by MPTXv2, and all were confirmed to be PTC by histopathology.

Both test versions demonstrated robust performance with low false‐positive molecular results. These data suggest that incorporation of MPTXv1, and more recently MPTXv2, into clinical practice within the Allegheny healthcare network resulted in improved accuracy of ITN risk stratification.

Patient management decisions are based on the independent medical judgment of the physician and molecular test results should be taken into consideration in conjunction with all relevant imaging, clinical findings, patient and family history, as well as patient preference.

Verma T, et al. The role of the ThyGeNEXT oncogene panel used in combination with the expanded miRNA panel ThyraMIRv2 in Indeterminate thyroid nodules: A large, blinded, real-world, observational study. Cancer Cytopathol. Published online May 30, 2024. doi:10.1002/cncy.22829.

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Patient management decisions are based on the independent medical judgment of the physician and molecular test results should be taken into consideration in conjunction with all relevant imaging, clinical findings, patient and family history, as well as patient preference.