Correlation of TIRADS scoring with preoperative fine needle aspiration biopsy and postoperative specimen pathology in thyroid nodules

Aim: By analyzing the association between fine needle aspiration biopsy and postoperative histopathological results, we want to determine the efficacy of TIRADS score of thyroid nodules in predicting malignancy. Materials and Method: Patients who underwent surgery for thyroid nodules after ultrasonographic evaluation and fine needle aspiration biopsy in the General Surgery Clinic of Çukurova University Faculty of Medicine between January 2014 and November 2021 were retrospectively analyzed in this study. Thyroid ultrasonography and fine needle aspiration biopsy of the participants in the research was made by a clinician with 15 years of expertise. The same clinician re-evaluated the ultrasonographic features of the nodules, and determined the ACR TIRADS score. The outcomes of fine needle aspiration biopsy were categorized using Bethesda. The results of the postoperative histopathological examination were split into two categories: benign and malign. The ACR TIRADS score was compared with the results of the fine needle aspiration biopsy and histopathology. The ACR TIRADS score's ability to predict malignancy was evaluated. Results: The mean age of the 397 patients was 50,9±12,8, and 79.8% of them were female. The mean diameter of the nodules was 27,4±15,8 mm. Between ACR TIRADS and Bethesda, there was a significant positive yet weak correlation. (p<0,001) (r=0.33) When the ACR TIRADS score and histopathological findings were compared, it was observed that as the TIRADS score increased, the rate of malignant diagnosis also increased (p<0,001). TR1 had a 0% malignant diagnostic rate, TR2 had a 13,2% malignant diagnosis rate, TR3 had a 21,7 percent malignant diagnosis rate, TR4 had a 50,3 percent malignant diagnosis rate, and TR5 had a 72,4 percent malignant diagnosis rate. For TI-RADS the area under the ROC curve for predicting malignancy was found to be 0.747 (95 percent CI: 0.699-0.796) (p<0,001) TR4 was determined to be the best suitable cut-off point with selectivity, with a sensitivity of 80.3 percent and a specificity of 60.8 percent. Conclusion: With a sensitivity of 80.3 percent and a selectivity of 60.8 percent, ACR TIRADS scoring is an efficient risk stratification system for thyroid nodules, with a 75 percent success rate in predicting malignancy.