Accuracy of ACR-TIRADS in assessment and diagnosis of thyroid nodules in patients underwent thyroid surgery in Taksin Hospital
Keywords:
Thyroid imaging reporting and data system (TIRADS), thyroid nodule, ultrasoundAbstract
Background: Ultrasound is generally considered most suitable to evaluate thyroid nodule sonographic morphology. The ultrasound-based risk stratification systems have been used to assess the probability of cancer in thyroid nodules.
Objective: To determine the efficacy of ultrasound-based American College of Radiology Thyroid Imaging Reporting and Data System (ACR-TIRADS) in estimating the risk of malignancy in thyroid nodules in Thailand.
Methods: A descriptive retrospective cross-sectional study was conducted at Taksin Hospital. In total, 324 patients with thyroid nodules underwent sonography and surgery; their pathological diagnoses were available, from January 2008 to April 2022. The ACR-TIRADS and ultrasound features were used to determine the risk of malignancy of thyroid nodules by using surgical histologic pathology from the tissue as the gold standard.
Results: Of the 324 cases, 276 females (85.2%) and 48 males (14.8%) were eligible for inclusion. The risk of malignancy in thyroid nodules according to ACR-TIRADS had a sensitivity of 94.8%, specificity of 79.3%, positive predictive value (PPV) of 50.0%, negative predictive value (NPV) of 98.6%, and accuracy of 82.1%. The ultrasound findings with high malignancy risks were extra-thyroidal extension, lobulated or irregular margin, taller-than-wide shape, very hypoechoic, punctate echogenic foci and enlarged cervical lymph nodes.
Conclusion: The ultrasound scoring-based ACR-TIRADS is a good indicator for evaluating cancer risk of thyroid nodules, determining further management, and reducing unnecessary thyroid biopsies.
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