Comparison of Sonographic-Based TI-RADS Classification and Cytological-Based Bethesda Scoring: 6-Month Experience in Somalia
Creators
- 1. Department of Radiology, Mogadishu Somalia-Turkey Recep Tayyip Erdoğan Training and Research Hospital, University of Health Sciences, Mogadishu, Somalia.
- 2. Department of Radiology, Mehmet Akif Inan Education and Research Hospital, University of Health Sciences, Şanlıurfa, Türkiye.
- 3. Department of Radiology, Harran University Faculty of Medicine, Şanlıurfa, Türkiye.
Description
Abstract
The aim of this study is to investigate the agreement between the thyroid image reporting and data systems (TI-RADS) classification and the Bethesda scoring in adults with thyroid nodules and to evaluate the effectiveness of our clinic in the management of thyroid nodules. In this prospective study, in which the analyzes of the patients who applied to the Interventional Radiology Department of our hospital for fine needle aspiration biopsy due to thyroid nodule were analyzed, 59 patients were included between January 1, 2020 and June 1, 2020. Sonographic features (composition, echogenicity, shape, margin, and echogenic foci) of all nodules were recorded for TI-RADS scoring before biopsy and TI-RADS scoring was performed by the radiologist. It was then the results compared with the Bethesda scoring, which is the cytological classification. A total of 59 patients (n=43; 72.9% female and, n=16; 27.1% male) were analyzed. Of the biopsied nodules, 31 (52.5%) were localized in the right lobe and 28 (47.5%) in the left lobe. The mean longest diameter of the nodules was 35.9±13.9 mm (range, 13-70 mm). The TI-RADS category was also significantly higher in those with larger nodule diameters (p=0.026). There was moderate agreement between both scorings (kappa value=0.406 and p<0.001). There were 7 (11.9%) patients with TI-RADS ≥ 4 and 10 (16.9%) patients classified as Bethesda ≥ 4. Thyroid nodules reported as highly suspected of malignancy (TIRADS ≥ 4) had good agreement with Bethesda scoring (Kappa value= 0.658 and p<0.001). According to the findings of our study, there is a moderate agreement between TI-RADS scoring and Bethesda. However, the rate of compliance was increasing in nodules classified as malignant nodules (TI-RADS ≥4).
Özet
Bu çalışmanın amacı tiroid görüntü raporlama ve veri sistemleri (TI-RADS) sınıflandırması ile Bethesda skorlaması arasındaki uyumu araştırmak ve tiroid nodüllerinin yönetiminde kliniğimizin etkinliğini değerlendirmektir. Bu prospektif çalışmada 1 Ocak 2020 ve 1 Haziran 2020 tarihleri arasında hastanemiz Girişimsel Radyoloji bölümüne tiroid nodülü nedeniyle ince iğne aspirasyon biyopsisi için başvuran hastalar analiz edildi. 18 yaş altındakiler çalışmaya dahil edilmedi. Biyopsi öncesi TI-RADS sınıflandırması için tüm nodüllerin sonografik özellikleri işlemi yapan radyolog tarafından kaydedildi (kompozisyon, ekojenite, şekil, kontur ve ekojenik odaklar). Sonrasında sonuçlar sitolojik sınıflandırma olan Bethesda skorlaması ile karşılaştırıldı. Çalışmaya toplam 59 hasta (n=43; %72.9 kadın ve n=16; %27.1 erkek) dahil edildi. Biyopsi yapılan nodüllerin %52.5’i (n=31) sağ lobda, %47.5’i (n=28) sol lobda lokalizeydi. Nodüllerin en uzun çapı ortalama 35.9±13.9 mm (minimum-maksimum; 13-70 mm) idi. Nodül boyutu büyük olanlarda TI-RADS kategorisi anlamlı olarak daha yüksekti (p=0.026). TI-RADS ve Bethesda skorlamaları arasında orta düzeyde bir uyum vardı (kappa değeri=0.406 ve p<0.001). Bethesda ≥ 4 olarak sınıflandırılan 10 (%16.9) ve TI-RADS ≥ 4 olan 7 (%11.9) hasta vardı. TI-RADS ≥ 4 olarak sınıflandırılan nodüllerde Bethesda ile uyum daha iyiydi (kappa değeri=0.658 ve p<0.001). Sonuçlarımıza göre TI-RADS skorlaması ile Bethesda sınıflaması arasında orta düzeyde bir uyum olup, malign özellikteki nodüllerde (TI-RADS ≥4) Bethesda sınıflaması ile olan uyum artmaktadır. Bu sınıflamanın rutin kullanıma girmesi malign nodüllerin daha kolay tespit edilmesini sağlayabilir.
Notes
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References
- 1. Shayganfar A, Hashemi P, Esfahani MM, Ghanei AM, Moghadam NA, Ebrahimian S. Prediction of thyroid nodule malignancy using thyroid imaging reporting and data system (TIRADS) and nodule size. Clin Imaging 2020; 60(2): 222-7.
- 2. Smith-Bindman R, Lebda P, Feldstein VA, Sellami D, Goldstein RB, Brasic N, et al. Risk of thyroid cancer based on thyroid ultrasound imaging characteristics: results of a population-based study. JAMA Intern Med 2013; 173(19): 1788-96.
- 3. Yılmaz S, Bölükbaşı H. The Importance of Using ACR-TIRADS Scoring System and Bethesda Classification System Together in the Diagnosis of Thyroid Cancer. J Ankara Univ Fac Med 2021; 74(1): 134-8.
- 4. Pazaitou-Panayiotou K, Capezzone M, Pacini F. Clinical features and therapeutic implication of papillary thyroid microcarcinoma. Thyroid 2007; 17(11): 1085-92.
- 5. Sugitani I, Toda K, Yamada K, Yamamoto N, Ikenaga M, Fujimoto Y. Three distinctly different kinds of papillary thyroid microcarcinoma should be recognized: our treatment strategies and outcomes. World J Surg 2010; 34(6): 1222-31.
- 6. Horvath E, Majlis S, Rossi R, Franco C, Niedmann JP, Castro A, et al. An ultrasonogram reporting system for thyroid nodules stratifying cancer risk for clinical management. J Clin Endocrinol Metab 2009; 94(5): 1748-51.
- 7. Tessler FN, Middleton WD, Grant EG. Thyroid Imaging Reporting and Data System (TI-RADS): A User's Guide. Radiology 2018; 287(1): 29-36. Erratum in: Radiology. 2018; 287(3): 1082.
- 8. Zloczower E, Atas O, London D, Elharar L, Jacobe-Levy M, Marom T. Agreement Between Ti-RADS Classification and Bethesda Cytopathological Findings from Thyroid Nodules in Young Adults. Mil Med 2020; 185(11-12): 2020-25.
- 9. Mauri G, Gitto S, Cantisani V, Vallone G, Schiavone C, Papini E, et al. Use of the Thyroid Imaging Reporting and Data System (TIRADS) in clinical practice: an Italian survey. Endocrine 2020; 68(2): 329-35.
- 10. Xie M, Gupta MK, Archibald SD, Jackson BS, Massey Ted Young JE, Zhang H. The Usefulness of the Thyroid Imaging Reporting and Data System in Determining Thyroid Malignancy. Laryngoscope 2020; 130(8): 2087-91.
- 11. Jinih M, Faisal F, Abdalla K, Majeed M, Achakzai AA, Heffron C, et al. Association between thyroid nodule size and malignancy rate. Ann R Coll Surg Engl 2020; 102(1): 43-8.
- 12. Grani G, Lamartina L, Ascoli V, Bosco D, Biffoni M, Giacomelli L, et al. Reducing the Number of Unnecessary Thyroid Biopsies While Improving Diagnostic Accuracy: Toward the "Right" TIRADS. J Clin Endocrinol Metab 2019; 104(1): 95-102.
- 13. Griffin AS, Mitsky J, Rawal U, Bronner AJ, Tessler FN, Hoang JK. Improved Quality of Thyroid Ultrasound Reports After Implementation of the ACR Thyroid Imaging Reporting and Data System Nodule Lexicon and Risk Stratification System. J Am Coll Radiol 2018; 15(5): 743-8.