World Journal of Endocrine Surgery

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VOLUME 13 , ISSUE 3 ( September-December, 2021 ) > List of Articles

Original Article

A 3-year Comparative Audit of Thyroid Nodule Ultrasound and Cytology Using TIRADS and Bethesda Scoring Systems

Reyaz M Singaporewalla, Bryan Wei S Seet, Anil D Rao, Venkateswaran Kotamma

Keywords : Audit, Bethesda classification, Concordance, FNAC, Thyroid nodule, Ultrasound TIRADS

Citation Information : Singaporewalla RM, Seet BW, Rao AD, Kotamma V. A 3-year Comparative Audit of Thyroid Nodule Ultrasound and Cytology Using TIRADS and Bethesda Scoring Systems. World J Endoc Surg 2021; 13 (3):75-80.

DOI: 10.5005/jp-journals-10002-1412

License: CC BY-NC 4.0

Published Online: 19-05-2022

Copyright Statement:  Copyright © 2021; The Author(s).


Introduction: Thyroid imaging reporting and data system (TIRADS) scoring is gaining popularity around the world among clinicians and radiologists. With any new practice, it is important to audit the results among different specialists and check concordance with the gold standard. We compared TIRADS scoring and thyroid nodule cytology data of two different surgeons to determine concordance and accuracy. Materials and methods: A retrospective analysis of records of patients with thyroid nodules managed under two specialist surgeons from 2016–2018 was performed comparing surgeon performed ultrasound (US) TIRADS grading with the Bethesda cytology classification. The TIRADS 2 and 3 lesions were corelated to Bethesda II (benign) results and TIRADS 5 was corelated to Bethesda V and VI (malignant) category. Data was also compared with our previously published audit in 2015. Results: A total of 254 thyroid nodules over a 3-year period, 208 cases (82%) were reported as benign disease and correlated to the TIRADS 2 and 3 grade given by the surgeon. Five were reported malignant which matched the TIRADS 5 score. Overall concordance rate for surgeon 1 and 2 were 79.7% and 87.2%, respectively. For each separate category, TIRADS 5 had the highest concordance at 100%, followed by TIRADS 3 at 91.9% and TIRADS 2 at 91.7%. None of the TIRADS 2 lesions were malignant. Sensitivity rates were similar at 71.1% compared to 70.6% in the previous audit. Conclusion: With proper training in TIRADS, we can achieve fairly good correlation between benign and malignant thyroid nodules among different surgeons and need for FNAC in TIRADS 2 lesions can be avoided. Clinical significance: This study shows importance of surgical audit. Good concordance rates can be achieved among different specialists with proper training.

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