Sonographic and cytological predictors of thyroid malignancy using TIRADS and Bethesda systems: a cross-sectional...

Thyroid nodules are among the most common endocrine disorders and present a variable risk of malignancy. Accurate preoperative assessment using clinical, sonographic, and cytological parameters is essential for appropriate management.

A prospective cross-sectional study was conducted on 70 patients presenting with thyroid complaints at Baghdad Teaching Hospital between January and June 2024. All participants underwent clinical evaluation, thyroid function testing, ultrasonography using the TIRADS classification, fine-needle aspiration cytology using the Bethesda system, and histopathological examination following surgery.

Multinodular goiter was the most prevalent thyroid condition in both sexes. Higher TIRADS grades, particularly Grade 5, and higher Bethesda categories were significantly associated with malignancy. Papillary carcinoma was the most frequent malignant histological type. Malignancy was more common among patients requiring re-aspiration. A positive family history and presentation with neck swelling were significantly associated with malignant nodules.

The combined use of TIRADS and the Bethesda system provides reliable prediction of thyroid malignancy. Family history and neck swelling are important clinical indicators that should prompt closer surveillance and early diagnostic intervention.