Correlation between thyroid image reporting and data system and fine-needle aspiration cytology in the assessment of suspicious thyroid nodules

Omran, Hisham M.; El-Shafei, Mahmoud A.; El-Badawy, Nafisa M.; Bassiouny, Ahmed M.; Abd Elrahman, Mohamed A.; El-Rifai, Ahmed Y.

doi:10.4103/ejs.ejs_217_21

Correlation between thyroid image reporting and data system and fine-needle aspiration cytology in the assessment of suspicious thyroid nodules

Authors

Abstract

Objectives
We are trying to evaluate both ultrasound criteria [based on thyroid image reporting and data system (TI-RADS) classification] and fine-needle aspiration cytology (FNAC) in the assessment of suspicious thyroid nodules by analyzing their results with the final histopathology outcome after thyroidectomy to detect their sensitivity and specificity in the differentiation of benign and malignant thyroid nodules.
Patients and methods
This is a prospective comparative study conducted in Ain Shams University Hospitals in Egypt from December 2018 to December 2020. The study included 50 patients suffering from suspicious thyroid nodules, either single or multiple nodules. Patients underwent ultrasound based on TI-RADS system and FNAC, then all patients underwent either total or hemithyroidectomy operation. Specimens were sent for histopathological examination, which is considered as gold standard. The results of TI-RADS and FNAC (based on Bethesda categories) were compared with the final histopathology outcome.
Results
The accuracy, sensitivity, specificity, positive predictive, and negative predictive value of FNAC were 80, 77.8, 98, 90, and 88.2% and TI-RADS values were 75, 88, 92, 81, and 76.6%, respectively. FNAC was less sensitive but more specific than TI-RADS. Our study found that the overall compatibility between TI-RADS and FNAC is 67% in the diagnosis of suspicious thyroid nodules (82.6% in benign cases, 68.4% in indeterminate cases, 50% in malignant cases).
Conclusion
TI-RADS is more sensitive in diagnosing suspicious thyroid nodules but FNAC is more specific, FNAC is a minimally invasive method that can be used to distinguish malignant from benign lesions with a high degree of accuracy (80%), and both TI-RADS and FNAC systems are effective diagnostic modalities for predicting malignant lesions in patients having suspicious thyroid nodules.

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