Abstract

Correlation between Tirads Ultrasound Criteria and Bethesda 2017 System for Reporting Thyroid Cytopathology: A Three Year Retrospective Study at a Tertiary Care Centre in Haryana, India

Author(s):Manika Mahajan, Manish Gulia, Sandhya Panjeta Gulia, Nisha Sharma, Samriddhi Sood*

Aims: Currently it is common in our country to advise ultrasound of the thyroid gland and fine needle aspiration cytology (FNAC) together for in case of nodular thyroid disease. Some recent studies on correlation of the ultrasound findings and the cytological findings seem to suggest that in many of such cases, FNAC can be avoided. The current study was undertaken to provide clarification in the matter. Material and Methods: This is a retrospective cross-sectional study carried out in Departments of Radiology and Pathology of a tertiary care hospital in Haryana, India between January 2018 and December 2020. The study included those patients diagnosed to be having thyroid nodules on ultrasound of the thyroid gland. These patients subsequently underwent ultrasound guided FNAC. On ultrasonography the thyroid nodules were categorised in to various TIRADS categories using the American College of Radiology TIRADS system. The cytopathological findings were categorised on the Bethesda 2017 system. The data from the ultrasonological and cytopathological systems was tabulated together and various statistical analysis values were obtained. Results: 492 patients were included in this study. After tabulating the data from the TIRADS and the Bethesda systems together, we obtained a sensitivity of 85.7%, specificity of 97.7%, positive predictive value of 52.2%, negative predictive value of 99.6%, and accuracy of 97.4%. Pearson Chi-square value was 212.4 and p-value <0.001 indicating significant association between the two systems. Area under ROC curve was 0.99 indicating that the results are very good. We calculated that 95% of our patients (belonging to TIRADS categories 2 & 3) had only 1.7% overall risk of malignancy. Conclusions: There is significant correlation between TIRADS and Bethesda systems for thyroid nodules. Vast majority of patients with thyroid nodules can be kept under follow-up following ultrasound examination and need not undergo the invasive FNAC procedure.

 

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