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Updated: Aug 4, 2025

Author Spotlight: Integrating Ultrasound Imaging with Biochemical Markers for Thyroid Disease Diagnosis
Published on: February 9, 2024
ACR TI-RADS Score combined with cytopathology classification improves the risk stratification of indeterminate
Francesco Feroci1, Davina Perini1, Alessio Giordano2
1Unit of General Surgery, Department of Surgery, Santo Stefano Hospital, Azienda ASL Toscana Centro, Prato, Italy.
Background:
The aim of this retrospective study was the elaboration of a new diagnostic model that integrate cytological reports (2017 Bethesda System for Reporting Thyroid Cytopathology) with ultrasonographic features (based on ACR TI-RADS score) to achieve a more accurate definition of indeterminate thyroid nodule malignancy risk.
Methods:
Ninety patients submitted to thyroidectomy were divided in three classes: low malignancy risk (AUS/FLUS with TI-RADS 2/TI-RADS 3 and FN/SFN with TI-RADS 2), intermediate malignancy risk (AUS/FLUS with TI-RADS 4/TI-RADS 5 and FN/SFN with TI-RADS 3/TI-RADS 4), and high malignancy risk (FN/SFN with TI-RADS 5).
Results:
The surgical approach should be recommended in high-risk patients (81.82% of malignancies), carefully evaluated in intermediate risk (25.42%), whereas a conservative approach can be adopted in low-risk patients (0.00%).
Conclusions:
The integration of these two multiparametric systems in a Cyto-US score has proven to be a feasible and reliable aid to achieve a more accurate definition of malignancy risk.
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