Radio Pathological Correlation of Thyroid Nodules Using Tirads Based Ultrasound Classification and Bethesda Classification for FNAC: a Prospective Study

Background: Thyroid gland is afflicted by various pathologies amongst which nodules are the cause of maximum concern because of their malignant potential. With the introduction of high resolution ultrasound and use of Thyroid imaging reporting and data system (TIRADS) classification as a widely used...

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Main Authors: Richa TIWARI, Ruchi GUPTA, Amit Kumar VERMA, Sanjeev KUMAR, Yogita KATIYAR
Format: Article
Language:English
Published: Bucharest College of Physicians 2020-09-01
Series:Modern Medicine
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Online Access:https://medicinamoderna.ro/wp-content/uploads/2020/09/RMM_art-11.pdf
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author Richa TIWARI
Ruchi GUPTA
Amit Kumar VERMA
Sanjeev KUMAR
Yogita KATIYAR
author_facet Richa TIWARI
Ruchi GUPTA
Amit Kumar VERMA
Sanjeev KUMAR
Yogita KATIYAR
author_sort Richa TIWARI
collection DOAJ
description Background: Thyroid gland is afflicted by various pathologies amongst which nodules are the cause of maximum concern because of their malignant potential. With the introduction of high resolution ultrasound and use of Thyroid imaging reporting and data system (TIRADS) classification as a widely used universal grading system, there has been reduced inter-observer variability and increased inter-departmental communication. In this study, we studied the TIRADS ultrasound grading as a screening tool and compared it with the BETHESDA grading on FNAC. Material and methods: 200 patients with thyroid nodules were subjected to ultrasound and USG guided FNAC. Each was assigned a TIRADS and Bethesda grade. Findings were compared to assess the sensitivity, specificity, PPV (positive predictive value) and NPV (negative predictive value) of ultrasound in differentiating benign from malignant nodules. RESULT: Out of 200 nodules examined, 116 nodules belonged to TIRADS 2 while 44, 13 and 27 belonged to TIRADS 3, 4 and 5 respectively. On FNAC, 162 patients belonged Bethesda 2 & 12, 7, 15 and 4 to Bethesda 3, 4, 5 and 6 respectively. The sensitivity, specificity, PPV and NPV of ultrasound were found to be 92.3, 90.8, 60 and 98.75 % respectively. Conclusion: TIRADS is an effective risk stratification system which should be routinely used in our clinical practice as it can predict the possibility of a particular nodule for being malignant to a great extent. Especially keeping in mind its high negative predictive value, FNAC can be deferred in TIRADS 2 patients which form a majority of cases reporting to pathology department for thyroid FNAC.
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spelling doaj-art-31c543a5a3554477a8ae13cdf732c8bc2025-08-20T02:15:51ZengBucharest College of PhysiciansModern Medicine1223-04722360-24732020-09-01273209213https://doi.org/10.31689/rmm.2020.27.3.209Radio Pathological Correlation of Thyroid Nodules Using Tirads Based Ultrasound Classification and Bethesda Classification for FNAC: a Prospective StudyRicha TIWARI0Ruchi GUPTA1Amit Kumar VERMA2Sanjeev KUMAR3Yogita KATIYAR4Department of Radiodiagnosis, SMMH Medical College, Uttar Pradesh, IndiaDepartment of Radiodiagnosis, Indira Gandhi Institute of Medical Sciences, Bihar, IndiaDepartment of Radiodiagnosis, King George’s Medical University, Uttar Pradesh, IndiaDepartment of Community Medicine, SMMH Medical College, Uttar Pradesh, IndiaDepartment of Pathology, SMMH Medical College, Uttar Pradesh, IndiaBackground: Thyroid gland is afflicted by various pathologies amongst which nodules are the cause of maximum concern because of their malignant potential. With the introduction of high resolution ultrasound and use of Thyroid imaging reporting and data system (TIRADS) classification as a widely used universal grading system, there has been reduced inter-observer variability and increased inter-departmental communication. In this study, we studied the TIRADS ultrasound grading as a screening tool and compared it with the BETHESDA grading on FNAC. Material and methods: 200 patients with thyroid nodules were subjected to ultrasound and USG guided FNAC. Each was assigned a TIRADS and Bethesda grade. Findings were compared to assess the sensitivity, specificity, PPV (positive predictive value) and NPV (negative predictive value) of ultrasound in differentiating benign from malignant nodules. RESULT: Out of 200 nodules examined, 116 nodules belonged to TIRADS 2 while 44, 13 and 27 belonged to TIRADS 3, 4 and 5 respectively. On FNAC, 162 patients belonged Bethesda 2 & 12, 7, 15 and 4 to Bethesda 3, 4, 5 and 6 respectively. The sensitivity, specificity, PPV and NPV of ultrasound were found to be 92.3, 90.8, 60 and 98.75 % respectively. Conclusion: TIRADS is an effective risk stratification system which should be routinely used in our clinical practice as it can predict the possibility of a particular nodule for being malignant to a great extent. Especially keeping in mind its high negative predictive value, FNAC can be deferred in TIRADS 2 patients which form a majority of cases reporting to pathology department for thyroid FNAC.https://medicinamoderna.ro/wp-content/uploads/2020/09/RMM_art-11.pdftirads (thyroid image reporting and data system)thyroid nodulesfi ne-needle aspiration cytologybethesda
spellingShingle Richa TIWARI
Ruchi GUPTA
Amit Kumar VERMA
Sanjeev KUMAR
Yogita KATIYAR
Radio Pathological Correlation of Thyroid Nodules Using Tirads Based Ultrasound Classification and Bethesda Classification for FNAC: a Prospective Study
Modern Medicine
tirads (thyroid image reporting and data system)
thyroid nodules
fi ne-needle aspiration cytology
bethesda
title Radio Pathological Correlation of Thyroid Nodules Using Tirads Based Ultrasound Classification and Bethesda Classification for FNAC: a Prospective Study
title_full Radio Pathological Correlation of Thyroid Nodules Using Tirads Based Ultrasound Classification and Bethesda Classification for FNAC: a Prospective Study
title_fullStr Radio Pathological Correlation of Thyroid Nodules Using Tirads Based Ultrasound Classification and Bethesda Classification for FNAC: a Prospective Study
title_full_unstemmed Radio Pathological Correlation of Thyroid Nodules Using Tirads Based Ultrasound Classification and Bethesda Classification for FNAC: a Prospective Study
title_short Radio Pathological Correlation of Thyroid Nodules Using Tirads Based Ultrasound Classification and Bethesda Classification for FNAC: a Prospective Study
title_sort radio pathological correlation of thyroid nodules using tirads based ultrasound classification and bethesda classification for fnac a prospective study
topic tirads (thyroid image reporting and data system)
thyroid nodules
fi ne-needle aspiration cytology
bethesda
url https://medicinamoderna.ro/wp-content/uploads/2020/09/RMM_art-11.pdf
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AT amitkumarverma radiopathologicalcorrelationofthyroidnodulesusingtiradsbasedultrasoundclassificationandbethesdaclassificationforfnacaprospectivestudy
AT sanjeevkumar radiopathologicalcorrelationofthyroidnodulesusingtiradsbasedultrasoundclassificationandbethesdaclassificationforfnacaprospectivestudy
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