Correlation of ultrasound and cytological diagnosis of thyroid nodule using TIRADS and bethesda classifications

Abstract

Aim: The objective of this study was to evaluate the compatibility between the two diagnostic methods used in the initial evaluation of individuals with a thyroid nodule, the TIRADS and Bethesda systems. Material and Methods: Between January 2020 and December 2022, FNA biopsies performed by a single interventional radiologist on 414 patients with thyroid nodules under US guidance were retrospectively reviewed. Demographic information of the patients, size of the nodules, echogenicity, TIRADS and BETHESDA scores were recorded and analyzed. Results: The mean age of the study population was 50.4 ± 14.2 years and the majority were female patients (74.9%). When thyroid nodules were classified according to TRIADS criteria, it was TIRADS TR2 in 29 (7%) patients, TIRADS TR3 in 147 (35.5%) patients, TR4 in 166 (40.1%) patients, and TR5 in 72 (17.4%) patients. The probability of malignant FNAC (Bethesda Class V and Class VI) in TIRADS classes 2, 3, 4, and 5 was 0%, 3.4%, 31.3%, and 66.7%, respectively. The probability of a benign FNAC (Bethesda Class II) in TIRADS category 2 was 100%, while for TIRADS classes 3, 4 and 5 it was 81.6%, 34.9% and 25%, respectively. Conclusion: Our study shows a good correlation between the Bethesda Classification of thyroid nodule FNAC and thyroid ultrasound reporting using the TIRADS classification. Correct interpretation of the two findings helps the clinician reduce the risk of unnecessary invasive procedures in patients who are unlikely to demonstrate thyroid cancer, while facilitating the identification of patients at high risk of cancer.

Keywords

• Fine-needle aspiration cytology
• Thyroid nodules
• TIRADS
• Bethesda
• Ultrasonography

TIRADS ve bethesda sınıflandırmaları kullanılarak tiroid nodülünün ultrason ve sitolojik tanısının korelasyonu

Abstract

Amaç: Tiroid nodülü olan bireylerin ilk değerlendirmesinde kullanılan iki tanı yöntemi TIRADS ve Bethesda sistemleri arasındaki uyumu değerlendirmektir. Gereç ve Yöntemler: Ocak 2020 ve Aralık 2022 yılları arasında tek bir girişimsel radyolog tarafından US kılavuzluğunda yapılan 414 tiroid nodüllü hastaya yapılan İİA biyopsileri retrosepektif olarak incelendi. Hastaların demografik bilgileri, nodüllerin boyutu, ekojenitesi ve kontur durumu, TIRADS ve BETHESDA skorları kaydedildi ve analiz edildi. Bulgular: Çalışma popülasyonunun ortalama yaşı 50.4 ± 14.2 idi ve çoğunluğu kadın hastalardı (%74.9). Hastaların ortalama nodül boyutu 18.36 ± 12.96 mm olarak ölçüldü. Tiroid nodülleri TRIADS kriterlerine göre sınıflandırıldığında 29 (%7) hastada TIRADS TR2, 147 (%35.5) hastada TIRADS TR3, 166 (%40.1) hastada TR4 ve 72 (%17.4) hastada TR5 idi. TIRADS 2, 3, 4 ve 5 sınıflarında Bethesda Class V ve Class VI olasılığı sırasıyla %0, %3.4, 31.3 ve %66.7 idi. TIRADS kategori 2'de Bethesda Sınıf II olasılığı %100 iken, TIRADS 3, 4 ve 5 sınıfları için sırasıyla %81.6, %34.9 ve %25 idi. Sonuçlar: Çalışmamız, tiroid nodülü İİAS'nin Bethesda Sınıflandırması ile TIRADS sınıflandırmasını kullanan tiroid ultrason raporlaması arasında oldukça iyi bir korelasyon olduğunu göstermektedir. İki bulgunun doğru yorumlanması, klinisyenin tiroid kanseri gösterme olasılığı düşük olan hastalarda gereksiz invaziv prosedür riskini azaltmasına yardımcı olurken, yüksek kanser riski taşıyan hastaların belirlenmesini kolaylaştırır.

Keywords

• İnce iğne aspirasyon sitolojisi
• Tiroid nodülleri
• TIRADS
• Bethesda
• Ultrasonografi

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