BACKGROUND: Thyroid imaging reporting and data system (TI-RADS) was designed to better select thyroid nodules (TN) to fine needle aspiration cytology (FNAC) with high sensitivity and accuracy. However, the comparison of TI-RADS scores in TN with Hashimoto’s thyroiditis (HT) (HTN+) versus TN without HT (HTN-) has not been examined so far. The aim of this study was to compare the diagnostic performance of TI-RADS score in TN associated or not associated to HT. METHODS: 308 unselected TN consecutively submitted to FNAC from June 2014 to March 2015 were included to compare the diagnostic performance of TI-RADS score in HTN+ and in HTN–; individual TI-RADS score was correlated to FNAC categories in all cases. All suspicious ultrasound features (hypoechogenicity, microcalcifications, irregular margins, taller-thanwide shape, central vascularization) of TN were classified according French TI-RADS categories using a risk score of malignancy. RESULTS: HTN+ had higher prevalence of suspicious/malignant cytology (Tir 4-5) (HTN+ 48/121 = 40%) compared to HTN– (40/163 = 29%, p < 0.05). The distribution of all TI-RADS categories (from 2 to 5) in HTN+ was not significantly different from that found in HTN– (Table). At difference with TI-RADS, the individual features of hypoechogenicity and irregular margins had higher prevalence in HTN+ (77/121 64%) than in HTN– (58/157 37%, p < 0.001), and were more present in suspicious/malignant cytology (TIR 4-5) (69/88 78%) than in benign (Tir 2) cytology (25/196 13%, p < 0.0001). CONCLUSIONS: This study confirms our previous observation of higher prevalence of malignant FNAC in nodules associated to HT. TI-RADS score appears not significantly influenced by presence of HT, in spite of the higher prevalence in HTN+ of individual suspicious ultrasound features such as hypoechogenicity and irregular margins and may be proposed as an useful diagnostic tool to select nodules for FNA independently from associated HT.
Thyroid imaging reporting and data system score: evaluation of risk stratification in thyroid nodules with Hashimoto’s Thyroiditis and thyroid nodules without Hashimoto’s thyroiditis underwent fine-needle aspiration cytology: results from a prospective study.
Pani F
;Boi F;Satta C;Serafini C;Casula S;Arisci N;Maurelli I;Mariotti S.
2016-01-01
Abstract
BACKGROUND: Thyroid imaging reporting and data system (TI-RADS) was designed to better select thyroid nodules (TN) to fine needle aspiration cytology (FNAC) with high sensitivity and accuracy. However, the comparison of TI-RADS scores in TN with Hashimoto’s thyroiditis (HT) (HTN+) versus TN without HT (HTN-) has not been examined so far. The aim of this study was to compare the diagnostic performance of TI-RADS score in TN associated or not associated to HT. METHODS: 308 unselected TN consecutively submitted to FNAC from June 2014 to March 2015 were included to compare the diagnostic performance of TI-RADS score in HTN+ and in HTN–; individual TI-RADS score was correlated to FNAC categories in all cases. All suspicious ultrasound features (hypoechogenicity, microcalcifications, irregular margins, taller-thanwide shape, central vascularization) of TN were classified according French TI-RADS categories using a risk score of malignancy. RESULTS: HTN+ had higher prevalence of suspicious/malignant cytology (Tir 4-5) (HTN+ 48/121 = 40%) compared to HTN– (40/163 = 29%, p < 0.05). The distribution of all TI-RADS categories (from 2 to 5) in HTN+ was not significantly different from that found in HTN– (Table). At difference with TI-RADS, the individual features of hypoechogenicity and irregular margins had higher prevalence in HTN+ (77/121 64%) than in HTN– (58/157 37%, p < 0.001), and were more present in suspicious/malignant cytology (TIR 4-5) (69/88 78%) than in benign (Tir 2) cytology (25/196 13%, p < 0.0001). CONCLUSIONS: This study confirms our previous observation of higher prevalence of malignant FNAC in nodules associated to HT. TI-RADS score appears not significantly influenced by presence of HT, in spite of the higher prevalence in HTN+ of individual suspicious ultrasound features such as hypoechogenicity and irregular margins and may be proposed as an useful diagnostic tool to select nodules for FNA independently from associated HT.
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