KLİNİK PRATİKTE ACR-TIRADS’IN UYGULANMASI

Abstract

Amaç Amerikan Radyoloji Koleji Tiroid Görüntüleme, Raporlama ve Veri Sistemi’nin tanısal doğruluğunu araştırmak Gereç ve Yöntem Ağustos 2017 ve Eylül 2018 arasında merkezimizde tiroid cerrahisi uygulanan 62 hastadan toplam 151 nodül toplanmıştır. Her bir nodülün ultrasonografik özellikleri iki radyolog tarafından kaydedilmiş ve Amerikan Radyoloji Koleji Tiroid Görüntüleme, Raporlama ve Veri Sistemi’ne göre sınıflanmış, ve histopatolojik olarak birebir karşılaştırılmıştır. Bulgular 151 tiroid nodül verisi ortanca boyutu ultrason ve patolojik spesimenler üzerinde sırasıyla 19 (3-85) mm ve 17 (0-97) mm olarak ölçülmüştür. Papiller karsinom 28 hastada (%45), papiller mikrokarsinom 14 hastada (%22.5), ve Hurthle hücreli karsinom 1 (%1.6) hastada saptanmıştır. Bu nodül risk belirleme modeli için genel sensitivite, spesifite, pozitif prediktif değer ve negatif prediktif değer sırasıyla %82.5, %57, %64.58, ve %77.67 olarak analiz edilmiştir. Sonuç İnce iğne aspirasyon biyopsisi için kesin bir boyut eşiği belirlemek yanlış yönlendirici olabilir, bunun yerine ultrasonda malign özelliklerin belirlenerek cerrahi kararın kişi bazında verilmesi önerilmelidir.

Keywords

• Mikrokarsinoma
• Sensitivite
• Spesifite
• TIRADS
• Tiroid nodülü

THE IMPLEMENTATION OF ACR TI-RADS IN CLINICAL PRACTICE

Abstract

Objective To investigate the diagnostic accuracy of the Thyroid Imaging, Reporting and Data System of the American College of Radiology in thyroid nodules. Material and Method A total of 151 nodules were collected from 62 patients undergoing thyroid surgery in our center between August 2017 and September 2018. Ultrasonographic features of each nodule were recorded and classified according to the Thyroid, Imaging Reporting and Data System of the American College of Radiology by two radiologists and compared with a one-to-one basis on histopathology. Results The median size of 151 thyroid nodules measured on the ultrasound and in the pathology specimens were 19 (3-85) mm and 17 (0-97) mm, respectively. Papillary carcinoma was demonstrated in 28 patients (45%), papillary microcarcinoma in 14 patients (22.5%), and Hurthle cell carcinoma in 1 (1.6%) patient. Overall sensitivity, specificity, positive predictive value, and negative predictive value for this nodule risk stratification model were analyzed as 82.5%, 57%, 64.58%, and 77.67%, respectively. Conclusion Setting a definitive size threshold for fine needle aspiration might be misleading, instead signifying the malignant features on ultrasonography, and making a decision for surgery on an individual base should be recommended.

Keywords

• Microcarcinoma
• Sensitivity
• Specificity
• Thyroid nodule
• TIRADS

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