Determination of Diagnostic Accuracy of ACR-TI-RADS in Detecting Malignancy in Thyroid Nodules On Ultrasonography, Keeping Bethesda Cytological Score at FNAC as Gold Standard: ACR-TI-RADS in Detecting Malignancy in Thyroid Nodules, Bethesda Cytological Score

Touseef Bilal Khan; Tarique Ali Shaikh; Sajjad Akram; Ramzan Ali; Werdah Zia; Tarique Khan; Sania Maqbool

doi:10.54393/pjhs.v6i3.2685

Authors

Touseef Bilal Khan Department of ENT, Mayo Hospital, Lahore, Pakistan
Tarique Ali Shaikh Department of ENT, Sharif Medical and Dental College, Sharif Medical City Hospital, Lahore, Pakistan
Sajjad Akram Department of ENT, Jinnah Hospital, Lahore, Pakistan
Ramzan Ali Department of Pediatric ENT, University of Child Health Sciences, Lahore, Pakistan
Werdah Zia Department of ENT, Arif Memorial Teaching Hospital, Rashid Latif Medical College, Lahore, Pakistan
Tarique Khan Department of ENT, Mayo Hospital, Lahore, Pakistan
Sania Maqbool Department of Physical Therapy, Lahore College for Women University, Lahore, Pakistan

DOI:

https://doi.org/10.54393/pjhs.v6i3.2685

Keywords:

Thyroid Nodules, ACR TI-RADS, Bethesda System, Fine Needle Aspiration Cytology

Abstract

Thyroid nodules are a common clinical concern, requiring precise evaluation to differentiate benign from malignant cases. Objective: To compare the diagnostic accuracy of the ACR TI-RADS with the Bethesda System, the gold standard for thyroid cytopathology. Methods: This cross-sectional study was carried out within the Diagnostic Radiology Division of Mayo Hospital Lahore between August and November 2024, and included 224 patients who had thyroid nodules on ultrasonography and were planned for fine needle aspiration cytology (FNAC). A radiologist assessed the ACR-TIRADS scores after data were accumulated employing a standardized case report form. The FNACs were categorized utilizing the Bethesda framework. SPSS version 29.0 was used to calculate the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of the ACR TI-RADS system. Results: Their study had a total of 224 patients, with a prevalence of female (186, 83.0%). The sensitivity of ACR TI-RADS in identifying malignant nodules was 87.5% (SE=0.049, 95% CI (77.9%, 97.1%)), while specificity was lower at 31.6% (SE=0.039, 95% CI (23.9%, 39.3%)). The PPV and NPV were 33.6% and 86.5%, respectively. Overall, the accuracy of ACR TI-RADS was 47.4%. Conclusions: It was concluded that the ACR TI-RADS system showed excellent sensitivity but low specificity in identifying malignant thyroid nodules. This implies that ACR TI-RADS is more useful for excluding cancer than identifying malignant instances. To improve the ACR TI-RADS system's predictability across a range of populations, more research is required.

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