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Does the ACR TI-RADS scoring allow us to safely avoid unnecessary thyroid biopsy? single center analysis in a large cohort

  • Endocrine Methods and Techniques
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Abstract

Introduction

The American College of Radiology (ACR) has recently proposed a guideline that recommends clinicians to perform thyroid fine-needle aspiration biopsy (FNAB) on the basis of ultrasound features. In this study, we focused on nodules for which no biopsy is recommended by the ACR Thyroid Imaging, Reporting and Data System (TI-RADS) guideline.

Subjects and methods

Two-thousand eight-hundred and forty-seven consecutive patients with thyroid nodules who underwent FNAB according to the 2009 American Thyroid Association (ATA) guideline were included. The nodules were re-classified according to the ACR TI-RADS guideline as benign (TR1), not suspicious (TR2), mildly suspicious (TR3), moderately suspicious (TR4) and highly suspicious (TR5). The TR3 category was stratified into two subcategories as regard to the nodule size (TR3; <25 mm and TR3; ≥25 mm).

Results

Two-hundred and thirty-three (8.2%) patients with non-diagnostic FNABs were excluded. When the TR2 and TR3; <25 mm categories were merged, FNAB was suggestive of thyroid cancer in 17 of 1382 patients (1.2%). FNAB revealed Bethesda IV–VI in 5 of 273 patients with the TR3; ≥25 mm category (1.8%), in 61 of 896 patients with the TR4 category (6.8%), and in 18 of 63 of patients with the TR5 category (28.6%). The ACR TI-RADS scoring was 98.8% (95% CI: 98 to 99.3) specific for identification of a benign nodule.

Conclusion

Our data suggest that ACR TI-RADS scoring is an applicable and potentially cost-effective approach to determine thyroid nodules to be biopsied, although a small proportion of thyroid cancers would be missed.

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Author notes

  1. These authors contributed equally: Fatos Dilan Koseoglu Atilla, Basak Ozgen Saydam.

Authors and Affiliations

  1. Department of Internal Medicine, Tepecik Training and Research Hospital, 35180,, Izmir, Turkey

    Fatos Dilan Koseoglu Atilla

  2. Division of Endocrinology and Metabolism, Dokuz Eylul University Faculty of Medicine, 35340,, Izmir, Turkey

    Basak Ozgen Saydam & Baris Akinci

  3. Department of Radiology, Tepecik Training and Research Hospital, 35180,, Izmir, Turkey

    Nihat Ali Erarslan

  4. Department of Pathology, Tepecik Training and Research Hospital, 35180,, Izmir, Turkey

    Ayse Gulden Diniz Unlu

  5. Division of Endocrinology and Metabolism, Tepecik Training and Research Hospital, 35180,, Izmir, Turkey

    Hamiyet Yilmaz Yasar

  6. Department of Internal Medicine, Dokuz Eylul University Faculty of Medicine, 35340,, Izmir, Turkey

    Muhammet Ozer

Authors
  1. Fatos Dilan Koseoglu Atilla
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  2. Basak Ozgen Saydam
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  4. Ayse Gulden Diniz Unlu
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Corresponding author

Correspondence to Basak Ozgen Saydam.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

The study was approved by Clinical Research Ethical Committee of Izmir Katip Celebi University Hospital (29.11.2013-No: 226). All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all participants before the FNAB and other procedures in consistency with the regulations of the national authorities. IRB approval was obtained to use the data.

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Koseoglu Atilla, F.D., Ozgen Saydam, B., Erarslan, N.A. et al. Does the ACR TI-RADS scoring allow us to safely avoid unnecessary thyroid biopsy? single center analysis in a large cohort. Endocrine 61, 398–402 (2018). https://doi.org/10.1007/s12020-018-1620-6

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  • DOI: https://doi.org/10.1007/s12020-018-1620-6

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