Cancer risk estimation using American College of Radiology Thyroid Imaging Reporting and Data System for cytologically indeterminate thyroid nodules

• Published in: The American journal of surgery Vol. 224; no. 2; pp. 653 - 656
• Main Authors: Dickey, Matthew V., Nguyen, Anne, Wiseman, Sam M.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-08-2022; Elsevier Limited
• Subjects: Accuracy; Bethesda; Biopsy; Cancer; Decision making; Diagnosis; Health risks; Histology; Malignancy; Medical diagnosis; Nodules; Pathology; Patients; Radiology; Regression analysis; Regression models; Risk of malignancy; Surgery; Thyroid; Thyroid cancer; Thyroidectomy; TI-RADS; Ultrasonic imaging; Risk of malignancy; Thyroid cancer; TI-RADS; Diagnosis; Bethesda
• ISSN: 0002-9610; 1879-1883
• DOI: 10.1016/j.amjsurg.2022.02.061

We sought to determine if using the ACR TI-RADS ultrasound score combined with the Bethesda diagnosis can help augment thyroid cancer risk estimation.
TI-RADS scores and Bethesda diagnoses were collected for patients treated in our center who had undergone thyroidectomy. Data from 186 patients with both TI-RADS scores and Bethesda diagnosis, and Bethesda diagnosis alone, were analyzed by multivariable regression analysis and observed for whether the pathology was benign or malignant.
The regression analysis model showed that as the TI-RADS score increases, the odds of malignancy increases as well. The predictive value of the odds of malignancy in a thyroid nodule using both Bethesda diagnosis and TI-RADS score together was more powerful than the odds given using the Bethesda diagnosis alone.
Our model shows that the ACR TI-RADS score may assist with preoperative decision-making for patients with cytologically indeterminate thyroid nodules when combined with Bethesda diagnosis.
•Combining TI-RADS score with Bethesda diagnostic grouping allows for more accurate preoperative thyroid nodule ROM estimation.•TI-RADS score of 5 increases the ROM estimation for thyroid nodules with any Bethesda diagnosis.•For Bethesda diagnostic groupings less than VI, the TI-RADS score was more predictive of ROM.