Correlation Between TIRADS Score by Ultrasonography and Thyroid Function Tests, Fine Needle Aspiration Cytology and Histopathology Findings of Thyroid Nodules

Prashanth G Patil

Abstract

Background: Thyroid nodules are a common presentation in otolaryngology-head and neck clinics. The detection of thyroid nodules has increased significantly with the advancements in radiological technology such as computed tomography and ultrasound. The present study aims to improve the clinical practice and management of thyroid disorders by establishing correlations between ultrasound and cytological findings in the diagnosis of thyroid nodules. The present study was conducted to study the ultrasound characteristics of thyroid nodule using TIRADS score and to correlate ultrasonography findings with Thyroid function test, fine needle aspiration cytology and HPE reports. Subjects and Methods: We have included age group of 20-60 years, patients willing to give informed consent, clinically diagnosed thyroid nodule. Thyroid ultrasound was performed with a Samsung UGEO H60 equipped with a 7-12 MHz linear-array transducer with color and power doppler capability. The ultrasound characteristics of the thyroid nodule was studied and categorized using TIRADS classification. Continuous variables are given in Mean SD/ Median (Min, Max) form. Applicability of TIRADS and FNAC to predict malignancy are obtained by simultaneously maximizing the sensitivity and specificity to obtain Cutoff value. P-value less than or equal to 0.05 indicates statistical significance. Results: The average age of our study population was 50.08 12.82 with majority of them between 41 to 50 years. Female predominance was observed, who accounted for about 88.6% of the study population. There was no association of nodules with thyroid profile. 16 (45.7%) had TIRADS of III, 13 (37.1%) had II. 4 (11.5%) subjects TIRADS was IV, 1 (2.8%) subject had I and 1 (2.8%) had V. 15 (42.9%) had BETHESDA III, 13 (37.1%) had II, 3(8.7%) subjects had IV, 2 (5.7%) had I. Cutoff of TIRADS II, 100 % sensitivity and 46.88% specificity and p=0.083, it is not predicting Malignancy. Cut off III had 25% sensitivity, which was almost same for BETHESDA II and III. Incidence of identifying malignancy by TIRADS III was 18.75% (2/16 TIRADS), for IV 25% (1/4 of TIRADS IV). Hence, TIRADS III and IV has better predictability of malignancy. Conclusion: There is no significant association in the distribution of affected lobes and their TIRADS score. Also, the distribution of TIRADS and BETHESDA had similar pattern with no significant difference. Mean values of Thyroid profile were in normal limits with no much deviation even among the malignant cases.