AI Article Synopsis
- The study investigates the correlation between ACR TI-RADS ultrasound scores and the risk of malignancy in cases with indeterminate thyroid fine needle aspiration cytology.
- A total of 46 cases were analyzed, revealing that most indeterminate cases had higher TI-RADS scores (TR4 and TR5) and that RAS mutations were the most common molecular alteration identified.
- The results suggest that while molecular testing is useful for TR4 and TR5 lesions, lower TI-RADS scores (TR2 and TR3) frequently showed no significant molecular changes, indicating the importance of ultrasound features in evaluating indeterminate cytology.
Article Abstract
Introduction: The American College of Radiology (ACR) Thyroid Imaging Reporting and Data Systems (TI-RADS) was developed to standardize thyroid ultrasound reports and predict the likelihood of malignancy. In our study, we aimed to correlate indeterminate thyroid fine needle aspiration cytology cases with preceding ultrasound (US) ACR TI-RADS scores and concurrent molecular testing results to examine how well the use of the ACR TI-RADS in our institution predicted which patients with indeterminate cytology might harbor molecular alterations.
Materials And Methods: We performed a retrospective review of thyroid nodules. Patients with US reports that included TI-RADS scores, fine needle aspiration specimens with indeterminate cytology (Bethesda class III-V), and molecular testing results were included.
Results: A total of 46 indeterminate cytology cases had had preceding US reports with TI-RADS scores and molecular testing (Bethesda class III, n = 37; Bethesda class IV, n = 6; Bethesda class V, n = 3). Most of the indeterminate cases had had a TI-RADS score of TR4 (31 of 46; 67.39%) or TR5 (9 of 46; 19.57%). RAS mutations were the most common alteration (n = 12). Of the 46 cases, 22 (47.85%) showed no alterations. Ten cases proceeded to surgery, of which seven displayed malignancies.
Conclusions: Molecular testing in cytologically indeterminate thyroid nodules provided valuable information for TR4 and TR5 lesions; however, the TR2 and TR3 lesions often had no molecular alterations. These findings highlight the potential value of including US imaging features when assessing the significance of indeterminate cytology findings.
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| http://dx.doi.org/10.1016/j.jasc.2022.01.002 | DOI Listing |
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