Original Research Article
Year: 2020 | Month: August | Volume: 7 | Issue: 8 | Pages: 6-14
Ultrasound Based Thyroid Imaging Reporting and Data System (ACR-TIRADS) In Risk Stratification of Malignancy in Thyroid Nodules
Anjana Rao1, Alpana Manchanda1, Anju Garg1, Shyam Lata Jain2
1Department of Radiodiagnosis, Maulana Azad Medical College, New Delhi
2Department of Pathology, Maulana Azad Medical College, New Delhi
Corresponding Author: Anjana Rao
ABSTRACT
Purpose: To evaluate thyroid nodules using gray scale sonography and color Doppler and categorise them as per American college of radiology (ACR) (2017) Thyroid imaging reporting and data system (TIRADS)1,2 classification. To assess diagnostic performance of TIRADS in detecting the risk of malignancy by comparing with cyto/pathological findings.
Materials and methods: We examined thyroid gland of 102 adult patients who presented clinically or incidentally with 201 thyroid nodules using ultrasound, after obtaining consent and relevant clinical history.
High resolution gray scale ultrasonography: The number and size of the nodules were recorded. Each nodule was evaluated for five sonological features : composition, echogenicity, shape, margin, presence and type of echogenic foci in the lesion. Each feature was assigned a point and a total score was calculated for each nodule and was assigned a specific TIRADS category (TR1 to TR5).
Color Doppler: All the thyroid nodule/s were examined and their vascularity pattern was categorised into one of the following types: absent, peripheral, intranodular or mixed (peripheral and intranodular). The diagnostic performance of ACR proposed TIRADS classification system was evaluated with FNAC (cytopathology) correlation in all patients.
Results and conclusions: The ACR proposed TIRADS is a reliable, highly specific and accurate classification system for stratifying thyroid nodules according to their risk of malignancy based on their sonographic features. This can be a useful tool towards standardizing a protocol for reporting and management of thyroid nodules. Furthermore, by following the ACR TIRADS recommendations FNACs can be avoided in a significant number of benign thyroid nodules.
Keywords: TIRADS, ACR TIRADS, TIRADS 2017, Thyroid ultrasound, Thyroid nodule, Thyroid cancer, Thyroid
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