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...

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Main Author:	Nagalindam, Deivind Kumar
Format:	Thesis
Language:	English
Published:	2021
Subjects:	R Medicine
Online Access:	http://eprints.usm.my/57293/1/DR%20DEIVIND%20KUMAR%20NAGALINGAM-24%20pages.pdf
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spelling	my-usm-ep.572932023-03-14T09:11:20Z Sonographic review of thyroid lesion based on ATA and ACR-tirads classification 2021 Nagalindam, Deivind Kumar R Medicine RC648-665 Diseases of the endocrine glands. Clinical endocrinology 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. 2021 Thesis http://eprints.usm.my/57293/ http://eprints.usm.my/57293/1/DR%20DEIVIND%20KUMAR%20NAGALINGAM-24%20pages.pdf application/pdf en public masters Universiti Sains Malaysia Pusat Pengajian Sains Perubatan
institution	Universiti Sains Malaysia
collection	USM Institutional Repository
language	English
topic	R Medicine R Medicine
spellingShingle	R Medicine R Medicine Nagalindam, Deivind Kumar Sonographic review of thyroid lesion based on ATA and ACR-tirads classification
description	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.
format	Thesis
qualification_level	Master's degree
author	Nagalindam, Deivind Kumar
author_facet	Nagalindam, Deivind Kumar
author_sort	Nagalindam, Deivind Kumar
title	Sonographic review of thyroid lesion based on ATA and ACR-tirads classification
title_short	Sonographic review of thyroid lesion based on ATA and ACR-tirads classification
title_full	Sonographic review of thyroid lesion based on ATA and ACR-tirads classification
title_fullStr	Sonographic review of thyroid lesion based on ATA and ACR-tirads classification
title_full_unstemmed	Sonographic review of thyroid lesion based on ATA and ACR-tirads classification
title_sort	sonographic review of thyroid lesion based on ata and acr-tirads classification
granting_institution	Universiti Sains Malaysia
granting_department	Pusat Pengajian Sains Perubatan
publishDate	2021
url	http://eprints.usm.my/57293/1/DR%20DEIVIND%20KUMAR%20NAGALINGAM-24%20pages.pdf
_version_	1776101197313212416

Sonographic review of thyroid lesion based on ATA and ACR-tirads classification

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