Evaluation of the Performance of ACR TI-RADS Also Considering Those Nodules with No Indication of FNAC: A Single-Center Experience.

Stefano Amendola Sium Wolde Sellasie Francesco Pedicini Massimo Carlini Giulia Russo Nicola Ossola Andrea Leoncini Flavia Botti Elena Bonanno Pierpaolo Trimboli Luigi Uccioli

J Clin Med

Division of Endocrinology and Diabetes, CTO Andrea Alesini Hospital, Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy.

Published: January 2023

Several risk stratification score systems for evaluating thyroid nodules exist, and this study aimed to assess the effectiveness of the American College of Radiology TI-RADS in distinguishing malignancy among nodules.
The research involved 830 nodules, with a significant percentage of those categorized as suspicious (TIR3B/TIR4/TIR5) ultimately proving to be cancerous after surgery.
The results suggest that the ACR TI-RADS guidelines for fine needle aspiration cytology (FNAC) may need to be updated, particularly to include more cases classified as TR4 nodules for further evaluation.

Background: Several US risk stratification score systems (RSSs) have been developed to standardize a thyroid nodule risk of malignancy. It is still a matter of debate which RSS is the most reliable. The purpose of this study is to evaluate: (1) the concordance between the American College of Radiology TI-RADS (ACR TI-RADS) and fine needle aspiration cytology (FNAC), (2) the cancer rate in the ACR TI-RADS categories, (3) the characteristics of nodules evaluated by FNAC even if not formally indicated according to ACR TI-RADS ('not indicated FNACs").

Methods: From January 2021 to September 2022, patients attending the Endocrinology Unit of the CTO Hospital of Rome for evaluation of thyroid nodules were included.

Results: 830 nodules had negative cytology, belonging to TIR2 and TIR1C. One hundred and thirteen nodules were determined to be suspicious for or consistent with malignancy belonging to TIR3B/TIR4/TIR5. Of this last group, 94% were classified as TR4/TR5 nodules. In total, 87/113 underwent surgery. Among these, 73 had histologically proven cancer, 14 turned out to be benign. "Not indicated FNACs" was 623. Among these, 42 cancers were present.

Conclusions: This study confirmed the diagnostic power of ACR TI-RADS. In addition, these data suggest revising the ACR TI-RADS indication to FNAC, especially for TR4.

Download full-text PDF	Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9865358	PMC
http://dx.doi.org/10.3390/jcm12020398	DOI Listing

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