A STUDY OF THE CONCORDANCE BETWEEN USG-TIRADS ASSESSMENT AND BETHESDA GRADING IN FNAC OF THYROID SWELLINGS AND ITS CORRELATION WITH HISTOPATHOLOGY
Main Article Content
Keywords
TIRADS Grading, Bethesda Classification, Thyroid Lesions.
Abstract
Background
Several studies have explored the correlation between TIRADS grading by ultrasound and Bethesda grading by cytology in the past. Most of them conclude that there is a positive correlation between the two and that using TIRADS scoring for evaluating thyroid lesions proves to be a major breakthrough in diagnostics. This study was conducted to analyse the correlation of radiological findings of thyroid lesions using TIRADS grading with their cytological features using the Bethesda Categorisation.
Methods
FNAC was conducted among 67 cases who had been evaluated radiologically and assigned appropriate TIRADS (Thyroid Imaging Reporting and Data Approach) scores. Cytological analysis using the Bethesda Categorisation was compared with the assigned TIRADS score, with histopathology as the gold standard.
Results
The sensitivity and specificity of TIRADS classification in differentiating benign and malignant neoplasms were 91.2% and 90%, respectively. The sensitivity and specificity of the Bethesda Classification in differentiating benign and malignant neoplasms were 94.7% and 80%, respectively. A positive correlation was achieved on comparing the Bethesda Classification and TIRADS grading with a p-value of 0.001 and the Pearson correlation r-value of 0.726.
Conclusion
The present study presents a highly significant positive correlation between TIRADS and TBSRTC. It highlights the combined use of radiological categorisation along with cytological categorisation as a better means of risk stratification of thyroid lesions.
References
[2] Haugen BR, Alexander EK, Bible KC, et al. American thyroid association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: the American thyroid association guidelines task force on thyroid nodules and differentiated thyroid cancer. Thyroid 2016;26(1):12-6.
[3] Mendes GF, Garcia MRT, Falsarella PM, et al. Fine needle aspiration biopsy of thyroid nodule smaller than 1.0 cm: accuracy of TIRADS classification system in more than 1000 nodules. Br J Radiol 2018;91:1083.
[4] Periakaruppan G, Seshadri K, Vignesh Krishna G, et al. Correlation between ultrasound-based TIRADS and Bethesda system for reporting thyroid-cytopathology: 2-year experience at a tertiary care center in India. Indian J Endocr Metab 2018;22(5):651.
[5] Pepper GM, Zwickler D. Roseny. Fine needle aspiration biopsy of the thyroid nodule results of a start up project in a general teaching hospital setting Ach Intern Med 1989;149(3):594-6.
[6] Bhatnagar S, Mohi J, Kaur N, et al. Correlation of tirads [Thyroid Imaging Reporting And Data System] and histopathological findings in evaluation of thyroid nodules. IJAR 2017;5(2):159603.
[7] Singaporewalla RM, Hwee J, Lang TU, et al. Clinico-pathological Correlation of Thyroid Nodule Ultrasound and Cytology Using the TIRADS and Bethesda Classifications. World J Surg 2017;41(7):1807–11.
[8] Handa U, Garg S, Mohan H, et al. Role of fine needle aspiration cytology in diagnosis and management of thyroid lesions: a study on 434 patients. Journal of Cytology 2008;25(1):13.
[9] George NA, Suresh S, Jiji V, et al. Correlation of TIRADS and Bethesda Scoring Systems with final histopathology of thyroid nodules - an institutional experience. Indian J Otolaryngol Head Neck Surg 2022;74(Suppl 3):5753-8.
[10] Krzysztof K, Dorota D, Beata W, et al. Fine-needle aspiration biopsy as a preoperative procedure in patients with malignancy in solitary and multiple thyroid nodules. PLoS One. 2016;11(1):e0146883.
[11] Horvath E, Silva CF, Majlis S, et al. Prospective validation of the ultrasound based TIRADS (thyroid imaging reporting and data system) classification: results in surgically resected thyroid nodules. Eur Radiol 2017;7:2619.
[12] Chandramohan A, Khurana A, Pushpa BT, et al. Is TIRADS a practical and accurate system for use in daily clinical practice? Indian J Radiol Imaging 2016;26:145-52.
[13] Srinivas MN, Amogh VN, Gautam MS, et al. A prospective study to evaluate the reliability of thyroid imaging reporting and data system in differentiation between benign and malignant thyroid lesions. J Clin Imaging Sci 2016;6:5.
[14] Moifo B, Takoeta EO, Tambe J, et al. Reliability of thyroid imaging reporting and data system (TIRADS) classification in differentiating benign from malignant thyroid nodules. Open J Radiol 2013;3:103.
[15] Barbosa TLM, Junior COM, Graf H, et al. ACR TI-RADS and ATA US scores are helpful for the management of thyroid nodules with indeterminate cytology. BMC Endocr Disord 2019;19:112.
[16] Abdelkader AM, Zidan AM, Younis MT, et al. Preoperative evaluation of thyroid nodules: a prospective study comparing the accuracy of ultrasound (TI-RADS) versus the FNAC Bethesda system in relation to the final postoperative histo-pathological diagnosis. Ann Pathol Lab Med 2018;5(10):A801-9.
[17] Vargas-Uricoechea H, Meza-Cabrera I, Herrera-Chaparro J. Concordance between the TIRADS ultrasound criteria and the BETHESDA cytology criteria on the nontoxic thyroid nodule. Thyroid Res 2017;10:1.
[18] Chaigneau E, Russ G, Royer B, et al. TIRADS score is of limited clinical value for risk stratification of indeterminate cytological results. Eur J Endocrinol 2018;179(1):13-20.
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Dr. Y. Sarasa Bharathi
Assistant Professor, Department of Pathology, Srinivasan Medical College Hospital, Trichy, Tamil Nadu, India.
Dr. S. Ragavendran
Assistant Professor, Department of Pathology, Government Medical College, The Nilgiris, Tamil Nadu, India.
Dr. Varshitha R. Kutchre
Senior Resident, Department of Pathology, PSP Medical College Hospital and Research Institute, Kanchipuram, Tamil Nadu, India.