Correlation of Thyroid Imaging Reporting and Data System (TIRADS) and histopathology. A single-center Observational Study
DOI:
https://doi.org/10.51985/Keywords:
Thyroid Nodule; Ultrasonography; Thyroid Neoplasms; Risk Assessment; Diagnostic ImagingAbstract
Objective: To correlate TIRADS with the final histopathology in patients undergoing thyroid surgery.
Study design & settings: prospective observational study at Department of ENT, Shaikh Zayed Hospital, Lahore. Methodology: We included 142 patients with thyroid nodules who underwent ACR TI-RADS-reported neck ultrasonography at our center followed by thyroid surgery. Histopathology was the reference standard. For diagnostic testing, TI-RADS 1- 3 were prespecified as test negative and TI-RADS 4-5 as test positive. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), diagnostic accuracy, and receiver operating characteristic (ROC) analysis were calculated.
Results: The largest age group was 30-39 years (42/142; 29.6%). There were 120 females and 22 males (female:male ratio approximately 5.5:1). TI-RADS distribution was TR1 3, TR2 23, TR3 62, TR4 48, and TR5 6. Histopathology showed 88 benign (62.0%) and 54 malignant (38.0%) nodules. Using TI-RADS 1-3 as test negative and TI-RADS 4-5 as test positive, sensitivity was 64.8%, specificity 78.4%, PPV 64.8%, NPV 78.4%, and diagnostic accuracy 73.2%. ROC analysis showed AUC 0.726 (95% CI 0.637-0.816; p<0.01), indicating approximately 72.6% discriminatory ability.
Conclusion: ACR TI-RADS showed a significant association with histopathology in this surgically selected tertiary-care cohort. Diagnostic performance was moderate, and the observed malignancy frequencies were not strictly monotonic across all categories. These findings should not be generalized to unselected thyroid-nodule populations without qualification
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