Correlation Between ACR TI-RADS and Bethesda System in Thyroid Nodules

Yıl 2025, Cilt: 35 Sayı: 5, 805 - 813, 28.10.2025

Emre Utkan Büyükceran , İsmail Dilek , Erbil Arık , Görkem Atasoy , Sezer Kula , Fatma Kaya , Sevcan Toraman , Murat Çalapkulu , Emre Can Çelebioğlu

Öz

Abstract
Background
Thyroid nodules are frequently encountered in clinical practice Fine-needle aspiration (FNA) cytology is a reliable method to assess malignancy potential, though most nodules are benign. The American College of Radiology Thyroid Imaging Reporting and Data System (ACR TI-RADS) standardizes ultrasound evaluation, aiding malignancy risk stratification and reducing unnecessary biopsies.
Methods
This retrospective study analyzed 182 patients who underwent thyroid ultrasound and FNA between August 2023 and August 2024. Nodules were classified using the ACR TI-RADS and Bethesda systems. Chi-square and receiver operating characteristic (ROC) curve analyses assessed correlations between classifications.
Results
The mean age was 49.77 years, with 159 females (87.36%) and 23 males (12.64%). Most nodules were categorized as ACR TI-RADS 3 (n = 120, 65.93%) and Bethesda 2 (n = 148, 81.32%), indicating benignity. Higher ACR TI-RADS scores correlated with increased malignancy risk, with ACR TI-RADS 5 nodules (n = 5, 2.75%) aligning with Bethesda 5 (n = 5, 2.75%). ROC analysis showed an area under the curve (AUC) of 0.93 for malignancy detection, demonstrating strong discriminatory power.
Conclusion
ACR TI-RADS aligns well with Bethesda results, effectively stratifying thyroid nodule risk and reducing unnecessary interventions.

Anahtar Kelimeler

Thyroid nodules , Fine-needle aspiration , Bethesda system , ACR TI-RADS

ACR TI-RADS ve Bethesda Sistemi Arasındaki Korelasyon: Tiroid Nodülleri Üzerine Bir Çalışma

Öz

Özet
Arka Plan
Tiroid nodülleri klinik pratikte sıkça karşılaşılan bir durumdur. İnce iğne aspirasyon (İİA) sitolojisi, malignite potansiyelini değerlendirmek için güvenilir bir yöntemdir, ancak çoğu nodül benign özellik taşır. Amerikan Radyoloji Koleji Tiroid Görüntüleme Raporlama ve Veri Sistemi (ACR TI-RADS), ultrason değerlendirmelerini standartlaştırarak malignite risk sınıflandırmasını kolaylaştırır ve gereksiz biyopsilerin önüne geçer.

Yöntemler
Bu retrospektif çalışmada, Ağustos 2023 ile Ağustos 2024 tarihleri arasında tiroid ultrasonografisi ve İİA yapılan 182 hasta analiz edilmiştir. Nodüller ACR TI-RADS ve Bethesda sistemlerine göre sınıflandırılmıştır. Sınıflandırmalar arasındaki korelasyon, ki-kare testi ve ROC eğrisi analizleriyle değerlendirilmiştir.

Bulgular
Ortalama yaş 49,77 yıl olup, katılımcıların 159'u kadın (%87,36) ve 23'ü erkekti (%12,64). Nodüllerin çoğu ACR TI-RADS 3 (n = 120, %65,93) ve Bethesda 2 (n = 148, %81,32) olarak sınıflandırılmıştır, bu da benignliği göstermektedir. Daha yüksek ACR TI-RADS skorları artan malignite riski ile korelasyon göstermiştir; ACR TI-RADS 5 nodüller (n = 5, %2,75) Bethesda 5 (n = 5, %2,75) ile uyum göstermiştir. ROC analizi, malignite tespitinde 0,93’lük bir eğri altındaki alan (AUC) ile güçlü bir ayrım gücü göstermiştir.

Sonuç
ACR TI-RADS, Bethesda sonuçlarıyla iyi bir uyum sağlamaktadır ve tiroid nodüllerinin risk sınıflamasında etkili bir yöntemdir. Aynı zamanda gereksiz müdahaleleri azaltmada da faydalıdır.

Anahtar Kelimeler

Tiroid nodülleri , İnce iğne aspirasyonu , Bethesda sistemi , ACR TI-RADS

Kaynakça

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