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Late-Breaking Scientific Oral Presentations

Head and Neck Surgery

Session: Late Breaking Scientific Orals 1

Performance of the ThyroSeq multigene genomic classifier: A ten-year institutional experience.

Saturday, October 11, 2025
3:18 PM - 3:24 PM EDT
Location: 245
Introduction: ThyroSeq molecular testing was developed to improve risk stratification for indeterminant thyroid nodules through comprehensive genomic analysis. Given a dearth of study evaluating ThyroSeq test performance across different versions and long-term institutional outcomes, this investigation assesses our institution’s ten-year experience with ThyroSeq using a retrospective approach.

Methods: Retrospective cohort study of patients ≥18 years who underwent ThyroSeq testing (2013-2022) for indeterminate thyroid nodules (Bethesda III-IV) followed by thyroidectomy and pathologic assessment at Penn State Health. Performance metrics including sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated and compared across ThyroSeq versions 1-3 as well as longitudinally over ten years.

Results: There were 159 patients who met inclusion criteria, with a mean age of 50.4±15.8 years. 73% were female. ThyroSeq was positive in 71.7% of cases, with final histopathology revealing malignancy in 52.2%. Overall test performance showed sensitivity 83.3%, specificity 28.8%, PPV 21.9%, and NPV 87.8%. Version comparison revealed that V3 had increased sensitivity and NPV but decreased specificity and PPV compared to V1. Longitudinal trends revealed variable performance metric results. Histological concordance was achieved in 57.1% of cases with predictions.

Conclusions: ThyroSeq demonstrates high sensitivity and NPV for detecting thyroid malignancy in indeterminate nodules, though specificity and PPV remain modest. Performance varies across versions, with newer iterations showing improved sensitivity at the cost of specificity. Our institutional experience yielded PPV and specificity values below those reported in original validation studies, consistent with other real-world independent evaluations. Surgeons should consider these performance limitations when using ThyroSeq results to guide clinical decisions.

    Presenting Author(s)

  • Andrew V. Meci, MPH

    Medical Student
    Penn State College of Medicine
    Hershey, Pennsylvania, United States

    Disclosure information not submitted.

    • Co-Author(s)

  • PK

    Pallavi P. Kulkarni, MD

    Resident
    Penn State Health/Milton S. Hershey Medical Center
    Hummelstown, PA, United States

    Disclosure information not submitted.

  • AG

    Alyssa Givens, MD

    Penn State Health Department of Otolaryngology - Head and Neck Surgery, United States

    Disclosure information not submitted.

  • HS

    Hayes Stancliff, BA

    Medical Student
    Penn State College of Medicine
    Hershey, PA, United States

    Disclosure information not submitted.

  • Emily N. Milarachi, MD, MSCI

    Resident, PGY 4
    Penn State Health Hershey Medical Center
    Hershey, PA, United States

    Disclosure information not submitted.

  • Kimberly H. Chan, MD

    Resident Physician
    Penn State College of Medicine
    Hummelstown, PA, United States

    Disclosure information not submitted.

    • Senior Author(s)

  • DG

    David Goldenberg, MD FACS

    Professor and Chair
    Hershey Med Center & Penn State Univ
    Hershey, Pennsylvania, United States

    Disclosure information not submitted.