Preoperative Evaluation of Thyroid Nodules: A Prospective Study Comparing the accuracy of Ultrasound (TI-RADS) Versus the FNAC Bethesda System in Relation to the Final Postoperative Histo-pathological Diagnosis

Ashraf M Abdelkader; Ahmed Mohamed Zidan; Mohamed Tawfeek Younis; Shaimaa Kamal Dawa

doi:10.21276/apalm.2110

Ashraf M Abdelkader General surgery department, Faculty of medicine, Benha University, EGYPT
Ahmed Mohamed Zidan General surgery department, Faculty of medicine, Benha University, EGYPT
Mohamed Tawfeek Younis General surgery department, Faculty of medicine, Benha University, EGYPT
Shaimaa Kamal Dawa Pathology Department, Faculty of Medicine, Benha University, EGYPT

DOI: https://doi.org/10.21276/apalm.2110

Keywords: Thyroid nodules, TI-RADS, Bethesda system, Thyroidectomy

Abstract

Objectives: We are trying to improve and detect the accuracy of the diagnostic tools of thyroid nodules by comparing the findings of thyroid ultrasound (US) using the thyroid image reporting and data system (TI-RADS) with the results of fine needle aspiration cytology (FNAC) that were reported according to the Bethesda system for reporting thyroid Cytopathology (TBSRTC), through matching the results of both maneuvers with the final postoperative (PO) pathology reports. Methods: The study included 100 patients suffering from thyroid swelling. Patients underwent ultrasound assessment using TI-RADS and FNAC biopsy using TBSRTC and then, all patients underwent thyroidectomy operation. Specimens sent to a laboratory for histological examination. The results of TI-RADS compared with Bethesda categories, and then both results were matched with the final histology reports. Data collected and statistically analyzed. Results: the overall concordance rate between US TI-RADS and TBSRTC is 67.6%. (82% in benign cases, 70.9%, in indeterminate cases, 50% in malignant cases). The overall concordance rate of results of TI-RADS versus FNAC with the final PO pathological results for predicting malignancy were (75.4%, 81.8%) with a sensitivity of (76.9 %, 81.8%) and specificity of (91.3%, 98%), positive predictive values were (PPV) (71.4%, 90%), and negative predictive values were (NPV) (76.4%, 96%), respectively. Conclusion: TI-RADS and TBSRTC classification systems could be considered as feasible and effective diagnostic modalities for predicting malignant lesions in patients had thyroid nodules. It's important for the clinicians to implement these diagnostic tests to improve their clinical performance and surgical outcomes.

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