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Thyroid Imaging Reporting and Data System (TI-RADS) Score Combined with Bethesda System for Malignancy Risk Stratification in Thyroid Nodules with Indeterminate Results on Cytology.
MedLine Citation:
PMID:  24930423     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
CONTEXT: The thyroid imaging reporting and data system (TI-RADS) was designed to better select patients who had undergone fine needle aspiration biopsies (FNABs) with high sensitivity and accuracy. However, the combination of TI-RADS scores and Bethesda system categories in indeterminate thyroid nodules has not been examined extensively.
OBJECTIVE: This study aimed to stratify indeterminate thyroid nodules (Bethesda categories III, IV and V) according to risk of malignancy as determined by combining TI-RADS score with Bethesda system classification.
DESIGN: Retrospective study. Histopathological, cytological and ultrasound (US) data were available for 242 cases after surgery, including 136 indeterminate nodules. MethodsAll thyroid cytopathological slides and US reports were reviewed and classified according to Bethesda system and TI-RADS categories. The malignancy rate was determined for each Bethesda category, TI-RADS score and both methods combined of indeterminate nodules.
RESULTS: The malignancy rate was 8.7%, 51.3% and 67.5% for Bethesda categories III, IV and V, respectively. Based on histopathological comparison, the accuracy was 66.7% for TI-RADS gray-scale. TI-RADS 3 and 4A scores were observed in 80% of Bethesda III cases, led to 80% sensitivity and 90% of negative predictive value (NPV). In contrast, for nodules scored as TI-RADS 4B and 5, the combined cytological results Bethesda IV and V resulted in a higher risk of malignancy (75% and 76.9%, respectively, P<0.001).
CONCLUSION: In view of the high NPV of TI-RADS 3/4A only in Bethesda III category, a surgical approach could be considered for lesions defined as Bethesda III, IV and V when TI-RADS 4B and 5 were concomitant. This article is protected by copyright. All rights reserved.
Authors:
Frederico F R Maia; Patrícia S Matos; Elizabeth J Pavin; Denise E Zantut-Wittmann
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-6-13
Journal Detail:
Title:  Clinical endocrinology     Volume:  -     ISSN:  1365-2265     ISO Abbreviation:  Clin. Endocrinol. (Oxf)     Publication Date:  2014 Jun 
Date Detail:
Created Date:  2014-6-16     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0346653     Medline TA:  Clin Endocrinol (Oxf)     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
This article is protected by copyright. All rights reserved.
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