Correlation between thyroid imaging reporting and data system and bethesda system of reporting of thyroid cytopathology of thyroid nodule: A single center experience

Abstract

Background: The incidence of thyroid cancer has been increasing worldwide. Thyroid imaging reporting and data system (TIRADS) has been proposed for risk stratification of thyroid nodules to improve categorical management. Fine needle aspiration cytology based on Bethesda system for reporting of thyroid cytopathology (BSRTC) plays a fundamental role in the evaluation of thyroid nodule microscopically. Both the systems, the TIRADS and the latest revised BSRTC 2017, are widely recommended and practiced all over the world, but the correlation between the two systems has not been established. Aims and Objectives: This study was conducted to assess the risk of malignancy (ROM) in the intermediate Bethesda categories of thyroid lesions and their correlation with the corresponding TIRADS categories. Materials and Method: It was a prospective cross-sectional study over 1 year including 69 patients aged 18 years or older having solitary thyroid nodules. All cases were triaged using both TIRADS and BSRTC 2017 and the diagnostic performances were compared with subsequent paraffin sections to evaluate ROM. Correlation between TIRADS and BSRTC systems was expressed as kappa value. Result: Good concordance was observed between TIRADS and BSRTC systems in the evaluation of benign thyroid nodule lesions (category 2-II). There was discordance in follicular lesions (category 4-IV). The kappa value generated (0.411) revealed moderate agreement between the two risk stratification systems. Conclusion: Careful application of both grading systems is essential for the proper segregation of thyroid nodules to facilitate effective clinical and surgical management. However, universally acceptable protocols need to be developed to avoid the heterogeneous approach.

Correlation of ultrasound‐based TIRADS and the Bethesda system for reporting of thyroid cytopathology: A study in a tertiary care centre

“…This can be attributed to the lack of TIRADS scoring in routine practice and the loss to follow-up of patients. It was mostly comparable with the study by Biswas et al9 , with the highest concordance for TIRADS-2, with ROM values of 10.3% and 10.8% respectively, and for TIRADS-5, with ROM values of 100% in both studies. Another study by Moifo et al14 found ROM values of 57.9% and 100% for TIRADS scores 4 and 5…”

“…The ROM in the present study for each TBSRTC category was much higher when compared to the standard TBSRTC system, especially for categories II to V. A 2020 study by Biswas et al 9 with a sample size of 69 cases found a ROM of 5.13% for category II, which was comparable to the TBSRTC system ROM of 0%‐3%; in the present study, a ROM of 11.3% was found for this category. The ROM for category III was 20% both in this study and that of Biswas et al The largest discrepancy was found in category IV, with a ROM of 61.5% in this study, 28.5% by Biswas et al, and 15%‐30% suggested by TBSRTC.…”

“…Another finding in this study was that 84.5% of cases in Bethesda category V had TIRADS scores of 4 and 5, while 96.9% of cases in Bethesda category VI had TIRADS scores of 4 and 5. A significant correlation was found between the TIRADS score and TBSRTC, with a p ‐value of < 0.001 and a Kappa agreement of 0.688; these values indicate substantial agreement, and the latter is higher than the moderate agreement with the Kappa value (0.411) reported by Biswas et al 9 …”

“…A study by Biswas et al 9 reported the highest concordance between TBSRTC‐II (56.5%) and TIRADS‐2 (53.6%); however, their sample size was small (69).…”

Agreement between Sonographic Features and Fine Needle Aspiration Cytology in the Diagnosis of Thyroid Nodules in a Tertiary Hospital

“…The investigators found that results for nodules categorized as TBSRTC II, V, and VI are comparable to previous studies. [9][10][11] Findings for nodules categorized as TBSRTC I and III were not previously elucidated.…”