Endocrine Abstracts

Background: TIRADS scoring is used to assess the thyroid nodules using USG, commonest used is ACR-TIRADS; another is K-TIRADS scoring. Nodule stiffness is assessed by elastography strain Rago scoring & FNA nodule gives lower (benign) or higher Bethesda (possible malignant) category report. The combined use of TIRADS & Rago scorings with Bethesda as final output can assess whether addition of elastography improves the correlation between thyroid nodule TIRADS scoring and FNA Bethesda categories.

Methods: This was a Cross sectional study in Endocrinology Deptarment, AIMS. Patients with STNs were assessed because it would not affect elastography findings. ACR-TIRADS, K-TIRADS & Rago scores were done and based on standard criteria, FNA was done with Bethesda categorisation. Those who have Bethesda category II grouped as one & categories III to VI (possible malignant) grouped as other group (higher Bethesda categories). Pearson’s Chi square test used for associations; in both groups, the data of ACR-TIRADS, K-TIRADS & Rago scores each alone; and combination of ACR-TIRADS with Rago & of K-TIRADS with Rago analysed with relation to prediction of higher Bethesda categories in them. ROC curves were plotted based on predicted probability scores and its AUC, sensitivity and specificity estimated.

Results: The AUCs for ACR-TIRADS, K-TIRADS & Rago scoring each alone in predicting higher Bethesda categories were not significant (sensitivity & specificity best for Rago alone); same for combined ACR-TIRADS & Rago scoring, and combined K-TIRADS & Rago scoring were statistically significant. Even though TIRADS scores were higher, the lower the elastography Rago score in nodules, the lower were the prediction probability of higher Bethesda categories in nodules.

Conclusions: This study showed that combination of USG elastography and TIRADS scoring data in cases of STNs, predicted higher Bethesda categories on FNA in them. Also showed that the lower the elastography Rago score in STNs, lower was the prediction probability of higher Bethesda categories, however higher the TIRADS scores were.