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Updated ACR Thyroid Imaging Reporting and Data Systems in risk stratification of thyroid nodules: 1-year experience at a Tertiary Care Hospital in Al-Qassim

The Egyptian Journal of Internal Medicine volume 31, pages 868–873 (2019)Cite this article

Abstract

Background

Thyroid imaging reporting and data system (TI-RADS) is assessment of risk stratification of thyroid nodules, using a score. A novel ACR (American College of Radiology) TI-RADS has been recently suggested by American College of Radiology. But, the utility of ACR TI-RADS in risk stratification for thyroid lesion needs further evaluation.

Aim

Of this study was to evaluate ACR TI-RADS classification in discriminating benign and from other thyroid lesions as detected by fine needle aspiration cytology (FNAC).

Methods

This retrospective study included all patients referred to our institute for FNAC of a thyroid nodule over 1 year. Thyroid nodules were categorized according to the 2017 ACR TI-RADS. Ultimately, efficacy of ACR TI-RADS in differentiating benign from non-benign nodules was assessed using ROC curve, cross-tabulation, and Chisquare tests. According to the results of FNAC, nodules were classified into 2 groups; benign lesions (Bethesda II) and malignant lesions (Bethesda IV, V).

Results

The percentages of Bethesda IV and V lesions defined in our ACR-TIRADS were as follows: ACR TI-RADS 1, 2 (0%), ACR TI-RADS 3 (4%), ACR TI-RADS 4 (6.6%), and ACR TI-RADS 5 (22.6%). ROC curve analysis for ACR TI-RADS to differentiate benign from non-benign pathology showed (AUC 0.60, 95% CI: 0.505–0.713). ACR TI-RADS had sensitivity, specificity, positive predictive value and negative predictive value 75%, 62.35 %, 15.7%, 96.3% respectively.

Conclusion

Differentiation between benign and malignant thyroid lesion can be suggested from the ultrasound based ACR TI-RADS system. FNAC might be deferred in patients having ACR TI-RADS 1 and 2.

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Authors and Affiliations

  1. Department of Internal Medicine, Faculty of Medicine, Sulaiman Al Rajhi Colleges, Al Bukayriyah, Saudi Arabia

    Mohammed Ewid

  2. Department of Internal Medicine, Faculty of Medicine, Cairo University, Cairo, Egypt

    Mohammed Ewid

  3. Diabetes and Endocrinology Unite, Kasr Al-Ainy Hospital, Cairo University, 41 Manial Street, Cairo, 11451, Egypt

    Mervat Naguib MD

  4. Department of Radiology, College of Medicine, Qassim University, Qassim, Saudi Arabia

    Ali Alamer & Sharifa Alduraibi

  5. Department of Pathology, King Fahad Specialist Hospital, Qassim, Saudi Arabia

    Hala El Saka

  6. Department of Pathology, Faculty of Medicine, Ain Shams University, Cairo, Egypt

    Hala El Saka

  7. Endocrinology and Diabetes Center, King Fahad Specialist Hospital, Qassim, Saudi Arabia

    Abdullah AlGoblan & Elzaki Ahmed

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  1. Mohammed Ewid
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  2. Mervat Naguib MD
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  3. Ali Alamer
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  4. Hala El Saka
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  5. Sharifa Alduraibi
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  7. Elzaki Ahmed
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Correspondence to Mervat Naguib MD.

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Ewid, M., Naguib, M., Alamer, A. et al. Updated ACR Thyroid Imaging Reporting and Data Systems in risk stratification of thyroid nodules: 1-year experience at a Tertiary Care Hospital in Al-Qassim. Egypt J Intern Med 31, 868–873 (2019). https://doi.org/10.4103/ejim.ejim_143_19

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  • DOI: https://doi.org/10.4103/ejim.ejim_143_19

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