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

Abstract

Objective: Ultrasonography (US) and fine-needle aspiration biopsy (FNAB) play an important role in the diagnosis of thyroid nodules. The primary aim of this study was to evaluate the relationship between American College of Radiology Thyroid Imaging Reporting and Data System (ACR TI-RADS) and the Bethesda system, based on final cytopathology. Materials and Methods: The cases that underwent thyroidectomy, due to a nodule, between May 2019 and May 2021 were retrospectively imaged. Of those cases, 73 patients were included in the study. The obtained data included ACR TI-RADS and the Bethesda system scores for nodules. Results: According to Spearman correlation, a very strong positive relationship was found between the Bethesda scoring system and ACR TI-RADS scores (ρ = 0.832, P < .0001). A 94.4% sensitivity and 65.4% specificity were found in 16 patients with a Bethesda score of 3 and TR3 based on final pathology ( P < .001). And a sensitivity of 77.3% and specificity of 51.5% were found in 17 patients, with a Bethesda score 4 and TR4 ( P < .001). Finally, a sensitivity of 55.6% and specificity of 50.0% were found in 17 patients with a Bethesda score 6 and TR5 ( P < .001). Conclusion: The routine use of the ACR TI-RADS classification in thyroid nodules could be useful in preventing unnecessary FNABs. It could be effective in minimizing complications secondary to FNAB and thyroidectomy and reducing costs.