medigraphic.com
ISSN 2539-0859 (Electronic)
ISSN 0120-8411 (Print)
Asociación Colombiana de Otorrinolaringología y Cirugía de Cabeza y cuello, Maxilofacial y Estética Facial (ACORL)

2022, Number 2

<< Back Next >>

Acta de Otorrinolaringología CCC 2022; 50 (2)

Concordance of the TI-RADS classification and the Bethesda System to detect malignancy in patients with thyroid nodule

Domínguez-Palomera LO, De Alba-Márquez ME, Adame-Betanzos OF, Sárda-Inman E, Vázquez-Navarro AP

Language: Spanish
References: 11
Page: 112-116
PDF size: 198.97 Kb.


ABSTRACT

Introduction: Evaluate the concordance of the TI-RADS classification and the Bethesda system to detect malignancy in patients with a thyroid nodule. Material and Methods: Through an observational, retrospective and cross-sectional study in 90 patients with a diagnosis of thyroid nodule, to which neck ultrasound was performed, definitive histopathological study and the TI-RADS (Thyroid Imaging Reporting and Data System) and Bethesda scales were applied during their approach from July 2018 to November 2020. Results: obtaining as a result, a predominance of the female sex, a sensitivity of 43.6% and specificity of 94.2% in classification of TI-RADS. Regarding the Bethesda classification, we obtained a sensitivity of 94.5% and a specificity of 51.4%. With a low agreement as a result between the two tests. Discussion: according to the results obtained in our study, we could verify that pa- tients with thyroid nodules benefit from an appropriate approach that includes a neck Doppler USG, performed by a trained professional, in addition to the realization of a Fine Needle Aspiration Biopsy (FNA) in the cases in which they are well indica- ted. The concordance test was low; therefore, we consider it necessary to use both diagnostic tests within clinical practice. Conclusion: the correct use of the TI-RADS classification to identify the characteristics of a thyroid nodule allows reliable diffe- rentiation to patients to undergo a FNA of those who do not require it. The Bethesda system can support decision making or change therapeutic behavior, especially in patients with high suspicion of malignancy.


REFERENCES

  1. Grani G, Lamartina L, Ascoli V, Bosco D, Biffoni M, GiacomelliL, et al. Reducing the Number of Unnecessary Thyroid BiopsiesWhile Improving Diagnostic Accuracy: Toward the “Right”TIRADS. J Clin Endocrinol Metab. 2019;104(1):95-102. doi:10.1210/jc.2018-01674

  2. Russ G, Bonnema SJ, Erdogan MF, Durante C, Ngu R,Leenhardt L. European Thyroid Association Guidelines forUltrasound Malignancy Risk Stratification of Thyroid Nodulesin Adults: The EU-TIRADS. Eur Thyroid J. 2017;6(5):225-237. doi: 10.1159/000478927

  3. Vargas-Uricoechea H, Meza-Cabrera I, Herrera-Chaparro J.Concordance between the TIRADS ultrasound criteria and theBETHESDA cytology criteria on the nontoxic thyroid nodule.Thyroid Res. 2017;10:1. doi: 10.1186/s13044-017-0037-2

  4. Zhuang Y, Li C, Hua Z, Chen K, Lin JL. A novel TIRADS ofUS classification. Biomed Eng Online. 2018;17(1):82. doi:10.1186/s12938-018-0507-3

  5. Skowronska A, Milczarek-Banach J, Wiechno W, ChudzinskiW, Zach M, Mazurkiewicz M, et al. Accuracy of theEuropean Thyroid Imaging Reporting and Data System (EU-TIRADS) in the valuation of thyroid nodule malignancy inreference to the post-surgery histological results. Pol J Radiol.2018;83:e579-e586. doi: 10.5114/pjr.2018.81556

  6. Gao L, Xi X, Jiang Y, Yang X, Wang Y, Zhu S, et al. Comparisonamong TIRADS (ACR TI-RADS and KWAK- TI-RADS) and2015 ATA Guidelines in the diagnostic efficiency of thyroidnodules. Endocrine. 2019;64(1):90-96. doi: 10.1007/s12020-019-01843-x

  7. Wu XL, Du JR, Wang H, Jin CX, Sui GQ, Yang DY, et al.Comparison and preliminary discussion of the reasons for thedifferences in diagnostic performance and unnecessary FNA biopsies between the ACR TIRADS and 2015 ATA guidelines.Endocrine. 2019;65(1):121-131. doi: 10.1007/s12020-019-01886-0

  8. Jin ZQ, Yu HZ, Mo CJ, Su RQ. Clinical Study of thePrediction of Malignancy in Thyroid Nodules: ModifiedScore versus 2017 American College of Radiology’s ThyroidImaging Reporting and Data System Ultrasound Lexicon.Ultrasound Med Biol. 2019;45(7):1627-1637. doi: 10.1016/j.ultrasmedbio.2019.03.014

  9. Trimboli P, Ngu R, Royer B, Giovanella L, Bigorgne C, SimoR, et al. A multicentre validation study for the EU-TIRADSusing histological diagnosis as a gold standard. Clin Endocrinol(Oxf). 2019;91(2):340-347. doi: 10.1111/cen.13997

  10. Singaporewalla RM, Hwee J, Lang TU, Desai V. Clinico-pathological Correlation of Thyroid Nodule Ultrasound andCytology Using the TIRADS and Bethesda Classifications.World J Surg. 2017;41(7):1807-1811. doi: 10.1007/s00268-017-3919-5

  11. Mistry R, Hillyar C, Nibber A, Sooriyamoorthy T, Kumar N.Ultrasound Classification of Thyroid Nodules: A SystematicReview. Cureus. 2020;12(3):e7239. doi: 10.7759/cureus.7239




2020     |     www.medigraphic.com