The efficiency of TIRADS scoring in thyroid nodules

THE EFFICIENCY OF TIRADS SCORING IN THYROID NODULES PURPOSE: The aim of this study is to evaluate the efficiency of TIRADS scoring system in the detection of malign or benign etiologic nodular growths of thyroid. MATERIALS AND METHODS: 155 patients with 172 thyroid nodules were included in this study. 131 of them were female and 41 of them were male. In all cases, nodules were evaluated retrospectively by a radiologist with more than 10 years experience in thyroid ultrasonography or another radiologist with 4 years experience. In all cases, localization of the nodules, solid or partial cystic formation, size, echogenicity, border characteristics, presence of microcalcification, height and width of nodule were evaluated. As a result of these evaluations, TIRADS is a scoring system that consists echogenicity, border characteristics, microcalcification, taller than wide shape of the nodules. According to this score; normal thyroid gland TIRADS 1; cystic nodules, nodules with large central cystic component, nodules in spongioform morphology, hyperechoic nodules in Hashimoto's thyroiditis TIRADS 2 (benign); iso and hyperechoic nodules without suspected features other than solid component presence TIRADS 3 (probably benign); solid and hypoechoic nodules TIRADS 4a (low suspicion) is a solid component of nodules containing one of the non-hypoechoic malignancy criteria 4b (intermediate suspicion), nodules containing any two or three suspicious criteria other than hypoechoic TIRADS 4c (high suspicion), four suspected nodules with features were classified as TIRADS 5 (highly likely malignant). Cytologic and histopathological diagnosis of all cases were obtained. TIRADS scores of all nodules were compared with cytologic and histopathological diagnosis. RESULTS: 172 thyroid nodules in 155 cases were evaluated. 142 of these nodules were benign, 30 were malignant. 26 of these malign nodules were diagnosed as papillary carcinoma (23 as classical type, 2 as follicular variant, 1 as oncocytic variant), 3 nodules diagnosed as medullary thyroid carcinoma and 1 nodule diagnosed as follicular carcinoma. As a result of univariate analyzes; suspicious sonographic features such as significant hypoechogenicity, border irregularity, microcalcification and taller than wide shape were found to be significantly IV associated with nodule malignancy. As the number of suspicious sonographic features increased in multivariate analysis, the risk of malignancy of the nodule was increased. Microcalcification was the most important factor that increases malignancy risk. In the first group, there were 1.5 cm large TIRADS 3 nodules and all nodules with higher TIRADS score. Sensitivity and negative predictive values were calculated as 100% and 100%, respectively. The second group included all nodules with TIRADS 4a and higher scores. Sensitivity and negative predictive value scores for malignancy were calculated as 90% and 96.6%, respectively. The 3rd group included all nodules with TIRADS 4b and higher scores. Sensitivity and negative predictive value fractions for malignancy were calculated as 76.7% and 93.9%, respectively. CONCLUSION: The TIRADS scoring system, based on the number of suspicious sonographic findings, is an effective scoring system in approach to thyroid nodules, predicting the risk of malignancy of the nodules and decision of FNAB. Keywords: Ultrasonography; TIRADS; thyroid.