Endocrine Abstracts

The prevalence of solid thyroid nodules is very high in the general population. Appropriate selection of cases for surgery is the most important task, when evaluating nodules. The present study wants to see if the use of Thyroid Imaging Reporting and Data System (TIRADS) could decrease the number of needed FNAB procedures.

Material and method: 174 nodules evaluated by conventional ultrasound and real time elastography, with linear multifrequency probe, Hitachi Preirus Machine, Hitachi, Inc. Prospective all nodules were classified by TIRADS system: ecogeneity (risk=inhomogeneity), margins (risk=irregular margins), shape (risk=irregular shape, taller than wide), calcification (risk=micro calcifications), lymph node (risk=presence), and increased strain (color map 4, 5, increased strain ration). TIRADS 4A, 4B, and 5 cases were referred also to FNAB. All 174 cases were operated and pathology report was obtained.

Results: Cancer was certified in 29 of the 174 operated thyroid nodules. The number of required punctions would be in 169 cases, if we consider the AACE guidelines. If we apply the TIRADS system (all 4A, 4B, and 5 TIRADS nodules) in selecting the cases for FNAB, the number would decrease significantly up to 74 nodules. The diagnostic quality of TIRADS is very high: using the ROC method, the AUC=0.95761, confidence limit of 0.8424–0.989 (95% LCL and 95% UPL). The sensitivity and specificity in diagnostic of cancer was excellent: diagnostic sensitivity, 86.20% with high specificity, 97.24%, with the best accuracy of 95.40%.

Conclusion: Using TIRADS system, the correct evaluation of the majority of the thyroid nodules is achieved.