Stratifying Indeterminate Cytology Thyroid Nodules by Combining Thyroid Imaging Reporting and Data Systems (TI-RADS) and The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC)

Authors

  • Steve Marlo Cambe, MD St Lukes Medical Center
  • Joseph Anthony M. Arañas, MD St. Luke’s Medical Center
  • Jamie Lynne P. Manzana, MD Institute of Radiology, St. Luke’s Medical Center https://orcid.org/0009-0005-2377-1208
  • Katleya Teresa G. Manlapaz, MD Institute of Radiology St. Luke’s Medical Center https://orcid.org/0009-0004-7456-915X

DOI:

https://doi.org/10.32412/pjohns.v38i2.1703

Keywords:

Cytologically Indeterminate Thyroid nodule, ACR TIRADS, Bethesda Classification, thyroid malignancy, thyroid ultrasonography, Ultrasound Guided- Fine Needle aspiration biopsy, thyroidectomy

Abstract

Objective: To determine the risk of malignancy of Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) indeterminate Thyroid  Nodules (Bethesda III, IV and V) by combining cytologic (TSBRTC) and Thyroid Imaging Reporting and Data Systems (TI-RADS) ultrasonographic features based on final histopathology.

Methods:
Design: Retrospective review of records
Setting: Tertiary Private Training Hospital
Participants: 551 records
Results: Among 81 eligible participants, 59 out of 84 nodules (70.24%) wer malignant on histopathology. The malignancy risk of Bethesda classification was 60.87% (28 out of 46) for Bethesda III, 57.14% (8 out of 14) for Bethesda IV and 95.83% for Bethesda V. The malignancy risk for TI-RADS categories was 0 % (0/1) for TI-RADS 2, 50% (10 out of 20) for TI-RADS 3, 71.05 % for TI-RADS 4 and 91.67 % for TI-RADS 5. The highest risk of malignancy (100%) was associated with [Bethesda IV/TI-RADS 1, 2, and 3], [Bethesda V/TI-RADS 1, 2 and 3 [Bethesda IV and V/TI-RADS 1, 2 and 3] and [Bethesda IV/TI-RADS 5]. The lowest risk of malignancy (33.33%) was associated with [Bethesda III/TI-RADS1, 2 and 3]. A high Bethesda classification (Bethesda V) was almost 5x more likely to have a malignant anatomorphology compared with Bethesda III (p = .05) while a TI-RADS 4 or 5 category was almost 5x more likely to have a malignant anatomorphology compared to TI-RADS 1, 2 or 3 (p = .026).


Conclusion: This study showed that TI-RADS scoring is a sensitive diagnostic classification in recognizing patients with thyroid cancer and combining Bethesda classification and TI-RADS scoring increases the sensitivity in the diagnosis of malignant thyroid nodules. A higher likelihood of malignancy is associated with higher Bethesda classification and TI-RADS scoring.

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Published

2023-11-20

How to Cite

1.
Cambe SM, Arañas JA, Manzana JL, Manlapaz KT. Stratifying Indeterminate Cytology Thyroid Nodules by Combining Thyroid Imaging Reporting and Data Systems (TI-RADS) and The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC). Philipp J Otolaryngol Head Neck Surg [Internet]. 2023 Nov. 20 [cited 2024 Apr. 24];38(2):42. Available from: https://pjohns.pso-hns.org/index.php/pjohns/article/view/1703