Comparison of Thyroid Imaging, Reporting and Data System (TI-RADS) classification with Fine Needle Aspiration Cytology (FNAC) for the Diagnosis of Thyroid Nodules

Mazhar Hussain; Mohammad Atif Shiraz; Muhammad Umar  Amin; Ghulam  Abbas; Raza Rahim  Haider; Sohail  Akhtar

doi:10.51253/pafmj.v76i3.10984

Authors

Mazhar Hussain Department of Radiology, Armed Forces Institute of Radiology & Imaging /National University of Medical Sciences (NUMS) Rawalpindi Pakistan
Mohammad Atif Shiraz Department of Radiology, Armed Forces Institute of Radiology & Imaging /National University of Medical Sciences (NUMS) Rawalpindi Pakistan
Muhammad Umar Amin Department of Radiology Akhtar Saeed Medical College Rawalpindi Pakistan
Ghulam Abbas Department of Radiology, Armed Forces Institute of Radiology & Imaging /National University of Medical Sciences (NUMS) Rawalpindi Pakistan
Raza Rahim Haider Department of Radiology, Armed Forces Institute of Radiology & Imaging /National University of Medical Sciences (NUMS) Rawalpindi Pakistan
Sohail Akhtar Department of Radiology, Armed Forces Institute of Radiology & Imaging /National University of Medical Sciences (NUMS) Rawalpindi Pakistan

DOI:

https://doi.org/10.51253/pafmj.v76i3.10984

Keywords:

Cytology, FNAC, Thyroid nodules, TI-RADS, Ultrasonography

Abstract

Objective: To assess how effective the TI-RADS (Thyroid Imaging Reporting and Data System) classification system is in categorizing thyroid nodules compared to fine needle aspiration.

Study Design: Cross-sectional study

Place and Duration of Study: Armed Forces Institute of Radiology & Imaging, PEMH Rawalpindi, Pakistan, from Feb to Aug 2023.

Methodology: A total of 130 male and female patients who presented with thyroid nodules were enrolled. High-frequency linear probes were used for ultrasonography of the neck /thyroid; findings were correlated with the TI-RADS scoring system described by Horvath et al. Patients underwent basic ultrasonography, and TIRADS scoring was performed with ultrasound-guided FNAC. A 23G needle was used for FNAC that was attached to 2 ml disposable syringe for aspiration. Each lesion was aspirated twice and cytological examination was performed.

Results: Majority of the patients 69(53.1%) were between the age of 41-55 years. Most of the thyroid nodules were detected as TI-RADS-II 73(56.2%) by USG classification. The association was significant between TI-RADS classification and cytology findings of thyroid nodules (p<0.001).

Conclusion: The association between TI-RADS classification and cytological findings from FNAC is significant and plays an important role in the evaluation of thyroid nodules.

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Author Biography

Raza Rahim Haider, Department of Radiology, Armed Forces Institute of Radiology & Imaging /National University of Medical Sciences (NUMS) Rawalpindi Pakistan

References

1. Zou B, Sun L, Wang X, Chen Z. The Prevalence of Single and Multiple Thyroid Nodules and Its Association with Metabolic Diseases in Chinese: A Cross-Sectional Study. Int J Endocrinol 2020; 2020: 5381012.

https://doi.org/10.1155/2020/5381012

2. Wang W, Kong L, Guo H, Chen X. Prevalence and predictors for malignancy of contralateral thyroid nodules in patients with unilateral PTMC: a systematic review and meta-analysis. Endocr Connect 2021; 10(6): 656-666.

https://doi.org/10.1530/EC-21-0164

3. Elbalka SS, Metwally IH, Shetiwy M, Awny S, Hamdy O, Kotb SZ, et al. Prevalence and predictors of thyroid cancer among thyroid nodules: a retrospective cohort study of 1,000 patients. Ann R Coll Surg Engl 2021; 103(9): 683-689.

https://doi.org/10.1308/rcsann.2021.0057

4. Chen Z, Mosha SS, Zhang T, Xu M, Li Y, Hu Z, et al. Incidence of microcarcinoma and non‐microcarcinoma in ultrasound‐found thyroid nodules. BMC Endocr Disord 2021; 21(1): 1-5.

https://doi.org/10.1186/s12902-021-00700-1

5. Soh SB, Aw TC. Laboratory Testing in Thyroid Conditions - Pitfalls and Clinical Utility. Ann Lab Med. 2019; 39(1): 3-14.

https://doi.org/10.3343/alm.2019.39.1.3

6. Langdon J, Gupta A, Sharbidre K, Czeyda-Pommersheim F, Revzin M. Thyroid cancer in pregnancy: diagnosis, management, and treatment. Abdominal Radiol 2023; 48(5): 1-16. https://doi.org/10.1007/s00261-023-03808-1

7. Jiang L, Lee CY, Sloan DA, Randle RW. Variation in the quality of thyroid nodule evaluations before surgical referral. J Surg Research 2019; 244(1): 9-14.

https://doi.org/10.1016/j.jss.2019.06.024

8. De D, Dutta S, Tarafdar S, Kar SS, Das U, Basu K, Mukhopadhyay P, Ghosh S. Comparison between Sonographic Features and Fine Needle Aspiration Cytology with Histopathology in the Diagnosis of Solitary Thyroid Nodule. Indian J Endocrinol Metab 2020; 24(4): 349-354.

https://doi.org/10.4103/ijem.ijem_349_20

9. Tuladhar AS, Pudasaini S, Simkhada S, Shrestha A, Pradhan S. Correlation of American College of Radiology (ACR)-Thyroid Imaging Reporting and Data System (TIRADS) findings in Ultrasonogram (USG) of thyroid nodules with FNAC or Biopsy findings. Nepal Med Coll J 2022; 24(1): 23-29.

https://doi.org/10.3126/nmcj.v24i1.44105

10. Thomas N, Menon U, Kumar H, Bhavani N, Praveen V, Nair V. Role of Strain Elastography in predicting possible malignant nature of thyroid nodules as a companion to TIRADS scoring. Indian Journal of Endocrinology & Metabolism. 2022; 26(Suppl 8): S10-S11.

https://doi.org/10.4103/2230-8210.363709

11. Wu Y, Xu T, Cao X, Zhao X, Deng H, Wang J, et al. BRAFV600E vs. TIRADS in predicting papillary thyroid cancers in Bethesda system I, III, and V nodules. Cancer Biol Med 2019; 16(1): 131-138.

https://doi.org/10.20892/j.issn.2095-3941.2018.0291

12. Altaf S, Mehmood Z, Baloch MN, Javed A. Experience of thyroid surgery at a tertiary care hospital in Karachi, Pakistan. Open J Thyroid Res 2019; 2(1): 005-008.

https://doi.org/10.17352/ojtr.000009

13. Khan R, Khan RA, Shehzad S, Naeem M, Jameel F, Gul J. Prevalence of Solitary Thyroid Nodule in Patients Admitted in Hospital of Dera Ismail Khan, KPK, Pakistan. Pak J Med Health Sci 2022; 16(09): 572-576.

https://doi.org/10.53350/pjmhs22169572

14. Malik N, Rauf M, Malik G. Comparison of TI-RADS classification with FNAC for the Diagnosis of Thyroid Nodules. J Islamabad Med Dental Coll 2020;9(2):129-133.

https://doi.org/10.35787/jimdc.v9i2.485

15. Dy JG, Kasala R, Yao C, Ongoco R, Mojica DJ. Thyroid Imaging Reporting and Data System (TIRADS) in Stratifying Risk of Thyroid Malignancy at The Medical City. J ASEAN Fed Endocr Soc 2017; 32(2): 108-110.

https://doi.org/10.15605/jafes.032.02.03

16. Zhuang Y, Li C, Hua Z, Chen K, Lin JL. A novel TIRADS of US classification. Biomed Eng Online 2018; 17(1): 82.

https://doi.org/10.1186/s12938-018-0507-3

17. Thattarakkal VR, Ahmed TSF, Saravanam PK, Murali S. Evaluation of Thyroid Nodule: Thyroid Imaging Reporting and Data System (TIRADS) and Clinicopathological Correlation. Indian J Otolaryngol Head Neck Surg 2022; 74(Suppl 3): 5850-5855.

https://doi.org/10.1007/s12070-021-02461-8

18. Vargas-Uricoechea H, Meza-Cabrera I, Herrera-Chaparro J. Concordance between the TIRADS ultrasound criteria and the BETHESDA cytology criteria on the nontoxic thyroid nodule. Thyroid Res 2017; 10(1): 1.

https://doi.org/10.1186/s13044-017-0037-2

19. Regmi S, Tiwari A, Sharma R. Comparison of fine-needle aspiration cytology in thyroid lesions using the Bethesda system for reporting thyroid cytopathology with ultrasonography using thyroid imaging reporting and data System. J Lumbini Med Coll 2018; 6(2): 1-5. https://doi.org/10.22502/jlmc.v6i2.274

20. Periakaruppan G, Vignesh KGM, Mandava R. Correlation between ultrasound based TIRADS and Bethesda system for reporting thyroid cytopathology: 2-year experience at a tertiary care center in India. Ind J Endocrinol Metab 2018; 22(5): 651–655. https://doi.org/10.4103/ijem.IJEM_27_18