Malignancy Rates in Thyroid Imaging Reporting and Data System Category 3 (TI-RADS 3) Thyroid Nodules: A Retrospective Study.

Introduction Thyroid cancer, one of the most frequently diagnosed endocrine malignancies, has witnessed a discernible global surge, predominantly among young adults. The etiological spectrum of thyroid cancer ranges from genetic mutations to environmental triggers. The early and precise detection of thyroid nodules (TNs) is crucial, given their latent potential for malignancy. Thyroid Imaging Reporting and Data System (TI-RADS) is an evidence-based stratification tool designed to standardize the assessment of TNs. Within this system, nodules categorized as TI-RADS 3 present an intermediate risk of malignancy, thereby necessitating meticulous evaluation. The objective of this study is to investigate the rates of cancer within thyroid nodules classified as TI-RADS 3, to determine the accuracy and effectiveness of the TI-RADS classification system in predicting malignancy at this intermediate-risk level, and to improve the diagnostic process and management strategies for these nodules. Methods A retrospective study was carried out on patients diagnosed with TI-RADS-3 thyroid nodules at King Fahad Hospital, Al-Hufof, between January 2019 and May 2023. Data were extracted from electronic medical records and encompassed patient demographics, and clinical and pathological details. Statistical analyses were performed using SPSS software version 27.0.1 (IBM Corp., Armonk, NY) examining the relationship between clinical characteristics and biopsy outcomes. Results The study involved 162 participants, mostly females (82.1%), with a median age of 43 years. Thyroid nodule analysis revealed 92.0% benign and 8.0% malignant cases, with the most common nodule size ranging from 2 to 2.4 cm. No significant correlation was found between clinical characteristics and biopsy results, indicating neither age nor gender significantly predicts malignancy in thyroid nodules within this cohort. Conclusion The majority of TI-RADS 3 nodules at King Fahad Hospital were benign. Yet, relying solely on TI-RADS for clinical decisions is not advised. An integrated approach, encompassing TI-RADS gradings and other nodule features, is essential for balanced patient management between intervention and observation.