Objective. To determine the accuracy of Thyroid Imaging Reporting and Data System (TIRADS) in detecting thyroid malignancy, determine risk of malignancy in each TIRADS category and determine the ultrasound characteristics associated with malignancy.Methodology. This is a retrospective cross-sectional study involving patients who underwent ultrasound, thyroid fine needle aspiration biopsy (FNAB) and thyroidectomy at The Medical City from January 2014 to December 2015. Ultrasound reports were retrieved and reviewed by two radiologists on separate occasions who were blinded to the cytopathology and histopathology results. The histopathology reports were correlated with ultrasound features to determine features associated with malignancy. Stata SE 12 was used for data analysis. TIRADS sensitivity, specificity, positive predictive values and negative predictive values and accuracy were calculated.Results. 149 patients with thyroid nodules were included. Solid composition is the ultrasound feature predictive of malignancy with adjusted OR 4.912 (95% Cl 1.3257 to 18.2011, p=0.017). The risk of malignancy for TIRADS categories 3, 4a, 4b, 4c and 5 were 12.50%, 12.82%, 26.19%, 53.70% and 66.67%, respectively. The Crude OR (95% CI) for TIRADS 4a, 4b, 4c and 5 were 1.03 (0.10 to 10.23), 2.48 (0.27 to 22.54), 8.12 (0.93 to 70.59) and 14.0 (0.94 to 207.60), respectively. The sensitivity, specificity, PPV, NPV and accuracy of TIRADS in relation to surgical histopathology report were 98.00%, 7.07%, 34.75%, 87.50%, and 53% respectively in TIRADS categories 4 and 5.Conclusion. This study showed that a solid nodule is the most frequent ultrasound feature predictive of thyroid malignancy. Higher TIRADS classification is associated with higher risk of thyroid malignancy. TIRADS is a sensitive classification in recognizing patients with thyroid cancer.

Objective. To compare the diagnostic performance of American College of Radiology-Thyroid Image Reporting and Data Systems (ACR-TIRADS) and the American Thyroid Association (ATA) guidelines on screening for thyroid malignancy. Methodology. A cross-sectional criterion-referenced study involving Filipino patients with thyroid nodules, 18-80 years old, who underwent ultrasound guided fine needle aspiration biopsy at the Thyroid Clinic of The Medical City from July to December 2019. The ACR-TIRADS and the ATA guidelines were compared for 197 nodules. Standard diagnostic parameters were calculated, namely sensitivity, specificity, PPV, NPV, positive and negative likelihood ratios and overall accuracies.Results. The risks of malignancy were 15% and 22% for TIRADS 4 and 5 respectively. For ATA guidelines, it's 2%, 20%, and 15% for nodules with low, intermediate, and high suspicion respectively. The sensitivity, specificity, PPV, NPV, and accuracy of the American College of Radiology Thyroid Imaging Reporting and Data System (ACR TIRADS) in relation to Fine Needle Aspiration Cytology (FNAC) is 100%, 52.2%, 16.5%, 100%, and 56.4% respectively. For the American Thyroid Association (ATA) guidelines it is 88.2%, 57.8%, 16.5%, 98.1%, and 60.4% respectively. Conclusion.The ACR TIRADS classifications appears to be more sensitive than the ATA classification. The ATA guidelines prove to be a more specific test. Each tool has its unique advantages and disadvantages. Therefore, clinicians must use these tools with utmost vigilance to avoid over or under diagnosis and to avoid unnecessary thyroid nodule biopsies.

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Objective. To determine the accuracy of Thyroid Imaging Reporting and Data System (TIRADS) in detecting thyroid malignancy, determine risk of malignancy in each TIRADS category and determine the ultrasound characteristics associated with malignancy.Methodology. This is a retrospective cross-sectional study involving patients who underwent ultrasound, thyroid fine needle aspiration biopsy (FNAB) and thyroidectomy at The Medical City from January 2014 to December 2015. Ultrasound reports were retrieved and reviewed by two radiologists on separate occasions who were blinded to the cytopathology and histopathology results. The histopathology reports were correlated with ultrasound features to determine features associated with malignancy. Stata SE 12 was used for data analysis. TIRADS sensitivity, specificity, positive predictive values and negative predictive values and accuracy were calculated.Results. 149 patients with thyroid nodules were included. Solid composition is the ultrasound feature predictive of malignancy with adjusted OR 4.912 (95% Cl 1.3257 to 18.2011, p=0.017). The risk of malignancy for TIRADS categories 3, 4a, 4b, 4c and 5 were 12.50%, 12.82%, 26.19%, 53.70% and 66.67%, respectively. The Crude OR (95% CI) for TIRADS 4a, 4b, 4c and 5 were 1.03 (0.10 to 10.23), 2.48 (0.27 to 22.54), 8.12 (0.93 to 70.59) and 14.0 (0.94 to 207.60), respectively. The sensitivity, specificity, PPV, NPV and accuracy of TIRADS in relation to surgical histopathology report were 98.00%, 7.07%, 34.75%, 87.50%, and 53% respectively in TIRADS categories 4 and 5.Conclusion. This study showed that a solid nodule is the most frequent ultrasound feature predictive of thyroid malignancy. Higher TIRADS classification is associated with higher risk of thyroid malignancy. TIRADS is a sensitive classification in recognizing patients with thyroid cancer.