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Published on: December 30, 2013
Diagnostic reliability of the Thyroid Imaging Reporting and Data System (TI-RADS) in routine practice
Allen San Shell Jabar1, Prakashini Koteshwara1, Jasbon Andrade1
1Department of Radiodiagnosis and Imaging, Kasturba Medical College, Manipal Academy of Higher Education (MAHE), Manipal, India.
Thyroid Imaging Reporting and Data System (TI-RADS) classifications by ACR and Kwak are reliable for assessing thyroid nodules. These systems help reduce unnecessary fine-needle aspiration cytology (FNAC) for benign lesions.
Area of Science:
- Radiology
- Oncology
- Endocrinology
Background:
- Thyroid nodules are common, and accurate risk stratification is crucial for appropriate management.
- Thyroid Imaging Reporting and Data System (TI-RADS) provides standardized criteria for ultrasound evaluation.
- Comparing different TI-RADS versions aids in optimizing diagnostic accuracy and reducing unnecessary procedures.
Purpose of the Study:
- To evaluate the diagnostic reliability of American College of Radiology (ACR) TI-RADS and Kwak et al. TI-RADS classifications.
- To calculate the risk of malignancy for each TI-RADS category.
- To assess the role of TI-RADS in reducing fine-needle aspiration cytology (FNAC) of benign thyroid lesions.
Main Methods:
- Prospective study of 127 thyroid nodules from December 2017 to August 2018.
- Nodules classified using ACR TI-RADS and Kwak et al. TI-RADS.
- Comparison of TI-RADS categorizations with cytopathological/histopathological diagnoses; calculation of malignancy risk, sensitivity, and specificity.
Main Results:
- Malignancy risk varied significantly across ACR TI-RADS categories (0% for TR1-2, up to 80% for TR5).
- Kwak TI-RADS showed malignancy risks from 0% (TR2-3) to 100% (TR4C).
- Kwak TI-RADS 2 and 3 demonstrated higher sensitivity (35.4%) for benignity prediction than ACR TR1 and 2 (25.9%).
Conclusions:
- TI-RADS classification is a reliable, non-invasive method for assessing thyroid nodules in clinical practice.
- TI-RADS can effectively help avoid unnecessary FNAC procedures for a significant number of benign thyroid lesions.
- Both ACR and Kwak TI-RADS systems offer valuable risk stratification for thyroid nodules.
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