A correlation study between thyroid imaging report and data systems and the Bethesda system for reporting thyroid cytology with surgical follow‐up‐ an ultrasound‐trained cytopathologist's experience

Abstract

Introduction Thyroid Imaging Reporting and Data Systems (TI‐RADS) including a modified system (M TI‐RADS) and American College Radiology (ACR) TI‐RADS are introduced. Correlation studies between both TI‐RADSs and The Bethesda System for Reporting Thyroid Cytology (TBSRTC) for Ultrasound‐guided fine‐needle aspiration (US‐FNA) cases with surgical follow‐up (SFU) are presented. Materials and Methods Three hundred and forty six thyroid US‐FNA cases performed at the US‐FNA clinic of Stony Brook University Hospital by an Ultrasound‐trained interventional Cytopathologist between December 1, 2014 to February 28, 2018 were reviewed. All ultrasound images from 346 cases were evaluated and assigned M TI‐RADS scores based on ultrasound features present in Table 1. One hundred and fifty four cases from Dcember 1, 2014 to February 28, 2016 were assigned scores using ACR TI‐RADS.TBSRTC category along with SFU data was collected and correlated with both TI‐RADS scores by using Pearson's correlation coefficient (r). Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and overall accuracy for M TI‐RADS and TBSRTC were also calculated using SFU diagnosis as a gold standard. McNemar test was applied to evaluate the significance of the difference between M TI‐RADS and TBSRTC. Results Based on 346 thyroid nodules studied, the overall r‐value between M TI‐RADS scores and TBSRTC categories is 0.465. The r‐values between Composition, Echogenicity, Shape, Margin, Echogenic foci, the summary points, and the converted TR level of ACR TI‐RADS and TBSRTC are 0.145, 0.042, 0.259, 0.310, 0.405, and 0.379, respectively. Fifty (14.5%) cases have SFUs. Considering TI‐RADS 5&6 and TBSRTC 5&6 as positives, and TI‐RADS 2 and TBSRTC 2 as negatives, the Sensitivity, Specificity, PPV, NPV, and accuracy are 96%, 53%, 76%, 89%, 79% for TI‐RADS vs 100%, 93%, 96%, 100%, 97% for TBSRTC, respectively (P = .038). The data for indeterminate cases are summarized. Conclusion Both TI‐RADSs could be helpful to a moderate degree. M TI‐RADS appeared to correlate to TBSRTC slightly better than that of ACR TI‐RADS. TBSRTC is significantly more accurate than M TI‐RADS for the majority of determined cases.

The Efficacy of ACR TI-RADS in the Management of Suspected Thyroid Nodules and Its Correlation With the Bethesda Scoring System

“…21 What made the present study different from almost all of the other studies was that it had final pathology results as well as Bethesda scores. 15,19,20 The current study has the highest positive correlation reported in the literature between the ACR TI-RADS and the Bethesda system. The reason why this very strong positive correlation (ρ = 0.832) was found between both classifications may be the intense focus on the Bethesda scoring system and the ACR TI-RADS relationship.…”

“…It was noted that modified TI-RADS correlated slightly better than ACR TI-RADS. 19 Modi et al evaluated 361 thyroid nodules classified by ACR TI-RADS and showed that this classification is more successful in detecting malignant lesions. A Bethesda score of 6 was noted in 14 cases with TR5; however, it was found that ACR TI-RADS was more successful, especially in TR4 and TR5 categories.…”

“…Unlike other studies, all of the US, FNAB procedures, and thyroid surgeries were performed in the same center in this study. 15,[18][19][20]…”

Overview of the Ultrasound Classification Systems in the Field of Thyroid Cytology

“…They found an overall 0.465 r-value between TI-RADS scores and TBSRTC categories. Furthermore, the comparative analysis between TBSRTC and TIRADS showed that sensitivity, specificity, PPV, NPV, and accuracy are 96%, 53%, 76%, 89%, 79% for TI-RADS vs. 100%, 93%, 96%, 100%, 97% for TBSRTC, respectively (p = 0.038) [39].…”

“…Various studies have evaluated the prediction of thyroid malignancy using TIRADS [25][26][27][28][29][30][31][32][33][34][35][36][37][38][39] (Table 3). Shayganfar et al studied 239 thyroid nodules combining TIRADS and FNA outcome using the Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) [25].…”