Sonographic review of thyroid lesion based on ATA and ACR-tirads classification
Background: Thyroid malignancy is one of the commonest cancers among adults with prevalence rate of 3-7%. High frequency ultrasound has been gold standard in detecting thyroid nodules and able to stratify malignant lesions. Research has been undertaken on these nodules with qualitative and quanti...
Saved in:
| Main Author: | |
|---|---|
| Format: | Thesis |
| Language: | English |
| Published: |
2021
|
| Subjects: | |
| Online Access: | http://eprints.usm.my/57293/1/DR%20DEIVIND%20KUMAR%20NAGALINGAM-24%20pages.pdf |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| Summary: | Background: Thyroid malignancy is one of the commonest cancers among adults
with prevalence rate of 3-7%. High frequency ultrasound has been gold standard in
detecting thyroid nodules and able to stratify malignant lesions. Research has been
undertaken on these nodules with qualitative and quantitative manners to stratify these
lesions. The purpose of this study is to compare stratification of thyroid lesions based on
ACR-TIRADS and ATA in detecting malignant thyroid nodules and analyse the sensitivity
and specificity of each scoring system.
Methods: A retrospective case-control study using sonographic images done prior
to the patient's thyroidectomy. Identified thyroid nodules were analysed using ATA and
ACR-TIRADS classification system for stratification and scoring. Variables such as age,
gender, family history, previous malignancy history and previous irradiation history were
documented in data collection form. For the purpose of our study, ATA benign and very
low suspicion nodule were categorized as benign and TR2 and below category was taken as
benign. On contrary to this, ATA low suspicion nodule with ACR-TIRADS TR3 category
and above were taken as malignant.
Results: A total of 129 nodules from 53 participants were included in this study. The
mean total identified benign thyroid nodule based on USG ATA classification showed 0%
benign and 3% were malignant on HPE. Meanwhile, based on benign USG ACR-TIRADS
features, 0.8% were benign and 3.9% were malignant. Malignant thyroid HPE based on ATA
and ACR-TIRADS classification was 93.0% and 91.0% respectively. The specificity, NPV
(Negative predictive value) and accuracy of ACR- TIRADS classification were high (95.2%, 97.6% and 93.0%) respectively. There was no significant association of each sonographic
characteristics ACR-TIRADS with HPE proven malignant thyroid nodules. A total of 28
nodules of category TR3(TIRADS 3) was identified as HPE (Histopathological
examination) proven malignancy with malignancy rate of 21.71%. in comparison to TR4
nodule and TR5 nodule of 10.08 % and 6.98% of detected malignancy rate.
Conclusion: Overall, this study showed that no single sonographic features of thyroid
nodule have significant association with malignant histology outcome of thyroid nodule.
However, combination of sonographic features improves predictability of
malignancy. Concisely, ACR-TIRADS is simple and practical method for thyroid nodule
stratification with high accuracy. |
|---|