THE IMPLEMENTATION OF ACR TI-RADS IN CLINICAL PRACTICE

Year 2023, Volume: 30 Issue: 3, 404 - 409, 23.09.2023

Bengi Balcı , Mehmet Üstün , Mustafa Bozdağ , Ali Er , Dudu Solakoğlu Kahraman , Cengiz Aydın

https://doi.org/10.17343/sdutfd.1306615

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

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

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