Endocrine Abstracts

Introduction: Nowadays, thyroid Ultrasound (US) is a reference exam and the best way for detection, diagnosis and monitoring of thyroid nodules suspect of malignancy. It allows selection of suspicious thyroid nodules for malignancy.

Our aim was to assess contribution of this exam using the TI-RADS score in order to establish the correlation with cytological results.

Materials and methods: A prospective study of 395 patients recruited within 12 months (2015–2016) was conducted leading to 400 samples. The Endocrinologist practiced himself thyroid US coupled with Doppler mapped each nodule according to the TI-RADS followed by a FNA including a sampling of the product by capillarity.

Cytological analysis was done by an experimented cytologist, in a center considered as a reference. Results were classified according to Bethesda’s classification.

Results: Among the 400 cytological analyses, 333 were classified as benign (83%), 11 were suspect of malignancy (3%) and 19 malignant (5%). The remaining 37 (9%) were difficult to classify and needed to be controlled.

Histological examination confirmed malignancy in the 30 suspicious and malignant cytological cases.

After comparison with US data it was found a TI-RADS’ score sensitivity of 88%, specificity of 92%, negative predictive value (NPV) of 98% and a positive predictive value (PPV) of 52%.

Conclusion: In this study, the PPV may be explained by focal thyroiditis frequency: the main differential diagnosis of thyroid carcinoma. Consequently, the integration of TI-RADS’ score data to the results of FNA remains a valuable approach to ensure a better thyroid nodules exploration.