Abstract #1412895: Comparison of Radiological Features of ATA and TIRAD System of Evaluating Thyroid Nodules - A Prospective Study in a Tertiary Care Hospital of Pakistan

Abstract

The occurrence of thyroid carcinoma had ascended through recent years. Excessive detection of thyroid nodules due to intensified use of thyroid ultrasonography and also increased FNAB (fine- needle aspiration biopsy) procedures are believed to cause the surge in the diagnosis of incidental papillary thyroid carcinomas. There have been two guidelines most commonly used in both clinical practice and scientific area; American Thyroid Association (ATA-2015) guideline and ACR-TIRADS (American College of Radiology - Thyroid Imaging Reporting and Data System) guideline. These guidelines have been established based on sonographic topographies and aim to distinguish nodules according to their doubt of malignancy to give recommendations for FNAB or follow-up. This study aims to compare the radiological features of ATA and TIRADS system of evaluating thyroid nodules. This was a prospective study, enrolling 105 patients. The patients presenting to Radiology Department of the study hospital with neck swelling/nodules for Ultrasound Neck and Thyroid were requested to participate in study after providing the informed consent. The participants must be of 18 years of age or above, however the patients with a known diagnosis of thyroid cancer or having recurrence of prior thyroid cancer were excluded. Proforma was filled as per ATA & ACR TI-RADS classification system. A few patients were followed with FNAB and Histopathology reports. Of all the nodules, 30 (28.5%) were benign, whereas 75 (71.5%) were malignant. ATA guidelines showed improved diagnostic efficiency than ACR TI-RADS (P<0.01). ACR TI-RADS confirmed a higher specificity (P<0.05), whereas the ATA outline had a higher sensitivity (P<0.01). The ACR-TIRADS and ATA guidelines performed better in differentiating nodules >1 cm. Both systems revealed good diagnostic presentation, however, ATA guidelines resulted in a superior number of thyroid biopsies or FNABs. Therefore, we believed that ACR-TIRADS is a better system in this regard, it can help us ruling out unnecessary biopsies.