Does ACR TI-RADS increase efficacy of thyroid ultrasounds?

The American College of Radiology Thyroid Imaging Results and Data System (ACR TI-RADS) is a risk stratification system (RSS) to assess ultrasounds of thyroid nodules. This study aims to evaluate if the implementation of ACR TI-RADS reduces fine needle aspiration cytology (FNAC) of benign nodules.

All patients diagnosed with a thyroid nodule, and who received an ultrasound between January 2018 and February 2020 were included. Period I included patients undergoing ultrasound before implementation of ACR TI-RADS and period II after implementation. The impact of ACR TI-RADS on the number of FNACs with the accompanying cytological results and guideline concordance were analyzed.

In this study, 787 patients and 889 ultrasounds were included. Of these ultrasounds, 403 were performed in period I and 486 in period II. The proportion of ultrasounds leading to FNAC decreased significantly since implementation (51.6 % vs. 43.6 %, p = 0.018) while the proportion of benign cytology results decreased significantly as well (84.4 % vs. 73.6 %, p = 0.020). Furthermore, since ACR TI-RADS implementation, physicians followed the accompanying guidelines on follow-up in 70.4 % of the cases.

A decrease of FNAC of benign thyroid nodules was observed since implementation of ACR TI-RADS and this RSS was easily implemented in our clinic.