Abstract
Aim. To analyse the effectiveness of TIRADS scale modified by Russ for prediction of thyroid cancer and comparison of diagnostic capabilities of the scale in patients with and thyroid nodules. Material and Methods. Patients, who underwent surgery for thyroid in period of 2015-2016 at the Department of Surgery No. 1 of the Lviv National Medical University were taken to research, and retrospective analysis was carried out. Stratification of thyroid cancer risk was performed by evaluation of ultrasonography findings according to the TIRADS scale. The obtained data were analysed for both and thyroid separately. Results and Discussion. In total, 1033 patients aged 17 to 82 years were operated for thyroid nodules. In 385 (37.3%) cases we failed to stratify by TIRADS due to lack of information in ultrasonographic description. Subsequent analysis was done over remaining 648 patients, among which 96 (14.8%) cases of cancer were proven. Patients were divided into 2 groups: Group I - cystic nodules - 164 (25.3%) patients; Group II - solid nodules - 484 (74.7%) patients. In group І thyroid cancer prevalence was 3.7%, while in group II it was 18.6%. The difference in thyroid cancer incidence had a significant statistical probability (c2=21.655; p <0.00001). There was a difference in the frequency of papillary microcarcinoma among and nodules: 1.2% and 3.5% respectively. In the prediction of cancer in patients with thyroid nodules, TIRADS scale demonstrated a high specificity of 93.0%, while the sensitivity was low - 16.7%. The TIRADS scale in assessing of thyroid showed a high overall diagnostic accuracy of 90.2%, but the level of positive predictive value for thyroid cancer among was low - 8.3%, especially when compared to - 44.1%. Conclusions. TIRADS is an effective method in predicting thyroid cancer, especially among nodules. Cancer prevalence among thyroid is significantly lower compared to nodules: 3.7% vs. 18.6%. The low sensitivity of the TIRADS scale in patients with thyroid is 16.7%, and therefore cases with graded TIRADS 2-4a require precise follow up.
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