Evaluation of Sonographic Features with TIRADS of Malignant Cytology, Suspicious for Malignancy, and Follicular Neoplasm Thyroid Nodules According to the Bethesda Reporting System

Abstract

Objective: Thyroid nodules are common and prevalence is 19-68% in the population. The gold standard diagnosis is fine needle aspiration cytology (FNAC). In this study, we examined the sonographic features of thyroid nodules with IV, V, VI [malignant cytology, malignancy suspected cytology (MC-MSC), and follicular neoplasia (FN)] according to the Bethesda Thyroid Cytopathology Reporting System (BTCRS). We aimed to evaluate its correlation with the American College of Radiologists' (ACR) Thyroid Imaging Reporting and Data System (TIRADS) classification. Methods: Ultrasound (US) features of 198 nodules detected as IV, V, and VI according to BTCRS in FNAC results were retrospectively examined. They were classified according to the ACR-TIRADS categorization from 1 to 5. Results: Of the 198 nodules, 153 were in MS-MSC and 45 were in FN. Female/male ratio; 155/43 and the mean age was 48.8+-13.1. The mean size of the nodules was 18.7+-9.3 mm. The mean size was 21.2+-9.2 mm in the FN group and 18+-9.3 mm in the MS-MSC group. Nodule size was found to be statistically significant in the FN group (p=0.013). The TIRADS score was found to be higher in the MS-MSC group (p=0.041). Ninety-three percent of the FN group and 92% of the MS-MSC group were based on a single nodule. Conclusion: TIRADS helps determine the malignant potential of thyroid nodules and prevent unnecessary biopsies. The presence of a single nodule may be a significant finding in malignancy. US features of follicular thyroid carcinoma may differ from typical TIRADS criteria, and size is a significant finding in distinguishing it from papillary thyroid carcinoma.

Keywords

• thyroid nodule
• tirads
• bethesda
• fine needle aspiration cytology