Evaluation of malignancy with thyroid imaging reporting and data system (TI-RADS) in thyroid nodules with persistent nondiagnostic cytology

Mustafa Ömer YAZICIOĞLU,Oya TOPALOĞLU,Reyhan ERSOY,Bekir ÇAKIR,Sevgül FAKI,Hayriye Tatlı DOĞAN,İbrahim KILINÇ,Afra ALKAN,Hüsniye BAŞER

doi:10.3906/sag-1811-198

Abstract

Background/aim We aimed to evaluate the utility of thyroid imaging reporting and data system (TI-RADS) in prediction of malignancy in thyroid nodules with persistent nondiagnostic (ND) cytology. Materials and methodsA total of 246 thyroid nodules which were surgically removed and had at least two fine-needle aspirations (FNAs) with ND cytology were included in this study. Ultrasonography features and TI-RADS scores were recorded. Results Of 246 nodules, 218 (88.6%) had benign and 28 (11.4%) had malignant final histopathology. Frequencies of taller than wide shape, solidity, hypoechogenicity, microcalciﬁcations, and presence of irregular borders were similar between benign and malignant nodules (P > 0.05). The number of nodules categorized as TI-RADS 3, 4a, 4b, and 4c were 12 (4.9%), 53 (21.5%), 104 (42.3%), and 77 (31.3%), respectively. There was not any nodule in TI-RADS 5 category. Malignancy rates of categories 3, 4a, 4b, and 4c were 0%, 13.2%, 9.6%, 14.3%, respectively. No significant differences were detected in TI-RADS categories between benign and malignant nodules (P > 0.05).ConclusionIn this study, we did not demonstrate any suspicious ultrasound (US) finding predictive for malignancy in thyroid nodules with persistent ND cytology and did not determine any difference between malignant and benign nodules regarding TI-RADS scores. Whereas, we found that thyroid nodules in 4a, 4b, and 4c TI-RADS categories had higher malignancy rates than those previously reported in ND cytology. We think that TI-RADS categories in thyroid nodules with persistent ND cytology can be helpful in treatment decision.

Highlights

Ultrasound (US)-guided fine-needle aspiration (FNA) is considered as the gold standard, accurate, costeffective, and safe procedure in evaluation of thyroid nodules [1,2]
Background/aim: We aimed to evaluate the utility of thyroid imaging reporting and data system (TI-RADS) in prediction of malignancy in thyroid nodules with persistent nondiagnostic (ND) cytology
Materials and methods: A total of 246 thyroid nodules which were surgically removed and had at least two fine-needle aspirations (FNAs) with ND cytology were included in this study

Summary

Introduction

Ultrasound (US)-guided fine-needle aspiration (FNA) is considered as the gold standard, accurate, costeffective, and safe procedure in evaluation of thyroid nodules [1,2]. The estimated rate of malignancy in ND cytology has been reported as 1%–4% in the literature, and in this setting US-guided FNA repetition is recommended [3]. The incidence of ND cytology has been reported in a wide range from 3% to 36.4% [2,4,5,6,7]. High risk US features for malignancy are solidity, irregular borders, microcalcifications, marked hypoechogenicity, and more tall than wide shape [8,10,11]. The thyroid imaging reporting and data system (TIRADS) is useful in risk stratification of thyroid nodules by using the number of high risk US features [12]

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