Correlation of Tirads [Thyroid Imaging Reporting and Data System] and Histopathological Findings in Evaluation of Thyroid Nodules.

Abstract

Purpose: Ultrasound [US] is an excellent noninvasive modality to evaluate thyroid nodules.Aim of our study was to characterize the thyroid nodules according to grey scale sonographic features into high suspicious ,probably benign, benign aspects and normal thyroid using TIRADS scoring system and to characterize the thyroid nodule according to the sonographic features into a specific TIRADS stage and correlate the results with the histopathological examination findings wherever possible. Material And Methods: The prospective study was carried out on 60 patients referred to Department of Radiodiagnosis, Rajindra Hospital,Patiala. All the patients were subjected to detailed history taking,clinical examination and routine laboratory investigations.All thyroid nodules were characterized according to the internal component[solid, mixed or cystic], the margins, echogenicity [hyperechoic, Isoechoic,hypoechoic, marked hypoehoic], evidence of calcification [microcalcification if less than 3mm and macrocalcification if more than 3mm with acoustic shadowing]and the shape[taller than wide if greater in anteroposterior dimension than in its transverse dimension and wider than tall]. Using the Modified Russ Classification, each nodule was classified into TIRADS categories [1,2,3,4A,4B and 5] based on ultrasound features.The patients were referred to Department of Pathology, Government Medical College Patiala and FNAC was done. The US findings were correlated with FNAC and data was analyzed statistically. Results: Based on various ultrasound characteristics of thyroid nodules,TIRADS score was given to each thyroid nodule and then FNAC was done.The results of histopathology were correlated with ultrasound features and statistical analysis was done calculating sensitivity, specificity,positive predictive value and negative predictive value for each feature.The sensitivity and specificity for Irregular contours were 44.4% and 94.12%,for taller than wide were 22.22% and 100%,for microcalcification were33.3.3% and 94.12%,for marked hypoechogenicity was 78 and 70.89% and for solid consistency were89 and 70.5%.The risk of malignancy was found to increase from TIRADS3 to TIRADS5 in this study. All the cases [100%] of TIRADS 5 turned out to be malignant on histopathology. Conclusion: Radiologists should be aware of usefulness of specific ultrasound features of thyroid nodules like Irregular contours, tallerCorresponding Author:-Simmi Bhatnagar.

Diagnostic performance of ACR-TIRADS ultrasound lexicon in risk stratification of thyroid nodules

“…Extra-thyroid extension (ETE) is considered in several risk systems for thyroid cancer, including ours (ACR-TIRADS US lexicon), because it is a critical predictor of clinical outcomes in differentiated thyroid cancer (DTC) patients. (23) In the present study, we found 16 nodules with extra-thyroid extension, and all of them revealed malignancy by pathology, confirming what other studies reported Azab et al (21) , Mohanty and Mishra (24) and Patil et al (25) where nodules with ETE had 100% malignancy risk.…”

“…Very hypoechogenicity, ETE, taller than wide nodules, and PEF had a 100%, 100%, 100%, and 95% risk for malignancy, respectively. Within the same line, Patil et al (25) mentioned that all nodules with marked hypoechogenicity and ETE had a 100% malignancy risk.…”

Correlation of Ultrasound Thyroid Imaging Reporting and Data System with Histopathology findings among patients in Uganda

“…Furthermore, irregular margins as well as taller than wider shapes are also predictors of malignancy albeit with low sensitivity of 31.8% while the speci city, positive and negative predictive values were almost 90%. Comparable ndings were reported by the same study from India (30) who observed that poorly de ned irregular margins had equally low sensitivity but high speci city and positive predictive value. These ndings are also similar to a study reported by Jabar et al that showed, irregular margin and taller than wider appearance had low sensitivity and PPV and high speci city and NPV (31).…”

A comparative study of sonographic evaluation of thyroid nodules, using TIRADS, with fine needle aspiration cytology

“…Various imaging modalities have been used in diagnosis of thyroid diseases. Thyroid volume can be calculated accurately by ultrasonography [2]. Sonographically, the normal thyroid parenchyma has a homogenous, medium to high level echogenicity.…”

“…The capsule of the thyroid gland is represented by a thin hyperechoic line around the thyroid lobes. The capsule can become calcified in patients with uremia or in disorders of calcium metabolism [2]. On Sonographic evaluation majority of the thyroid nodules are asymptomatic and are detected incidentally [3][4][5] Ultrasonography followed by USG guided FNAC is usually done in evaluating any thyroid nodule that is palpable on physical examination.…”