DOI: http://dx.doi.org/10.18203/2349-2902.isj20213121

Diagnostic value of thyroid imaging reporting and data system in thyroid nodules

Elsayed Ahmed Mostafa, Radwa Mohamed Atia, Muhammad Salah Ragab Abdel-Aal

Abstract


Background: The improved detection of TNs (TNs) with US has resulted in an increase in the number of thyroid fine needle aspiration biopsy (FNAB). Appropriate criteria are necessary to avoid an increase of rather unnecessary benign cytologic results in TNs. Thyroid imaging reporting and data system (TIRADS) was first used by Horvath et al in 2009. This was to standardize the reporting of results of thyroid (ultrasonography) US that can be understood by clinicians and also stratify the risk of malignancy of a lesion based on the US features of the lesion.

Methods: Cases with uninodular or multinodular goiter had been included. Evaluation of cases had been done using ultrasound of the neck. TNs were classified into categories according to thyroid imaging reporting and data system of the American colleague of radiologists (ACR-TIRADS).Cases were ordered for fine needle aspiration cytology (FNAC). Operable cases were only included in the study and postoperative histopathology was revised.

Results: The study included 46 patients. The different TIRADS categories were confronted with the results of cytology and histopathology. Combining TIRADS 2 and 3 as probably benign categories and TIRADS 4 and 5 as probably malignant categories, the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were respectively 100%, 84.38%, 73.68% and 100%. The accuracy of ACR-TIRADS was 89.13%.

Conclusions: ACR-TIRADS helps in stratifying nodular thyroid disease based on the risk of malignancy. It could lead to a significant decrease of the number of unnecessary FNABs.


Keywords


Thyroid, ACR, TIRADS

Full Text:

PDF

References


References

Hoang JK, Lee WK, Lee M, et al., (2007) : US Features of Thyroid Malignancy: Pearls and Pitfalls 1. Radiographics;27(3):847-60.

Abdullah N, Mesurolle B, El-Khoury M, Kao E,( 2009): Breast Imaging Reporting and Data System Lexicon for US: Interobserver Agreement for Assessment of Breast Masses. Radiology;252(3):665-72.

Ganguly A, Burnside G , Nixon P (2014): A systematic review of ultrasound-guided FNA of lesions in the head and neck—focusing on operator, sample inadequacy and presence of on-spot cytology service‏ . B J radiol 2014‏ - birpublications.org

Horvath E, Majlis S, Rossi R, et al.,(2009):An ultrasonogram reporting system for thyroid nodules stratifying cancer risk for clinical management. The Journal of Clinical Endocrinology & Metabolism;94(5):1748-51.

Grant EG, Tessler FN, Hoang JK, et al., (2015): Thyroid ultrasound reporting lexicon: white paper of the ACR Thyroid Imaging, Reporting and Data System (TIRADS) Committee. J Am Coll Radiol;12:1272-9.

Tessler FN, Middleton WD, Grant EG, et al.,(2017): ACR Thyroid Imaging, Reporting and Data System (TI-RADS):White Paper of the ACR TI-RADS Committee. J Am Coll Radiol 2017;14:587–595.

Dean DS & Gharib H, (2008): Epidemiology of thyroid nodules. Best Practice & Research Clinical Endocrinology & Metabolism;22(6):901-11.

Kim DW, Lee YJ, Eom JW, et al., (2013): Ultrasound-based diagnosis for solid thyroid nodules with the largest diameter <5 mm.Ultrasound Med Biol; 39:1190–1196.

Moon WJ, Jung SL, Lee JH, et al., (2008): Thyroid Study Group, Korean Society of Neuro- and Head and Neck Radiology. Benign and malignant thyroid nodules: US differentiation multicenter retrospective study. Radiology; 247:762–770.

Morganti S, Ceda G, Saccani M, et al., (2004): Thyroid disease in the elderly: sex-related differences in clinical expression. Journal of endocrinological investigation;28(11 Suppl Proceedings):101-4.

Modi L, Sun W, Shafizadeh N,et al.,(2020): Does a Higher American College of Radiology Thyroid Imaging Reporting and Data System (ACR TI-RADS) Score Forecast an Increased Risk of Malignancy? A Correlation Study of ACR TI-RADS With FNA Cytology in the Evaluation of Thyroid Nodules. Cancer Cytopathol 2020;0:1-12.2020 American Cancer Society.

Singaporewalla RM , Hwee J , Lang TU,et al.,(2017): Clinico-pathological Correlation of Thyroid Nodule Ultrasound and Cytology Using the TIRADS and Bethesda Classifications. World J Surg.

Dy JG, Kasala R, Yao C,et al.,(2017): Thyroid Imaging Reporting and Data System (TIRADS) in Stratifying Risk of Thyroid Malignancy at The Medical City. J ASEAN Fed Endocr Soc.32(2): 108–116.

Nasser HM & Aleem M,(2019): Thyroid Imaging Reporting and Data System (TIRADS) Versus Thyroid Scan for Solitary Thyroid Nodules Med. J. Cairo Univ., Vol. 87, No. 6, September: 3789-3794, 2019.