The association between the ultrasonography TIRADS classification system and surgical pathology among indeterminate thyroid nodules

Zeyad T. Sahli, Farah Karipineni, Jen Fan Hang, Joseph K. Canner, Aarti Mathur, Jason D. Prescott, Sheila Sheth, Syed Z. Ali, Martha A. Zeiger

Research output: Contribution to journalArticlepeer-review

Abstract

Background: A high proportion of cytologically indeterminate, Afirma-suspicious thyroid nodules are benign. The Thyroid Imaging Reporting and Data System was proposed by the American College of Radiology in 2015 to determine appropriate management of thyroid nodules in a standardized fashion. Our aim was to determine the diagnostic value of the Thyroid Imaging Reporting and Data System in cytologically indeterminate and Afirma-suspicious nodules. Methods: We retrospectively queried cytopathology archives for retrospectively for thyroid fine-needle aspiration specimens obtained between February 2012 and September 2016 that were associated with the following: (1) indeterminate diagnosis, (2) ultrasonographic imaging at our institution, (3) an Afirma Gene Expression Classifier–suspicious result, and (4) surgery at our institution. We then calculated the diagnostic value of the Thyroid Imaging Reporting and Data System in predicting surgical pathology. Results: Our cohort consisted of 133 nodules among 131 patients who underwent thyroid surgery for cytologically indeterminate, Afirma-suspicious nodules. A total of 9 nodules (6.8%) were assigned TR2 “not suspicious,” 25 (18.8%) TR3 “mildly suspicious,” 81 (60.9%) TR4 “moderately suspicious,” and 18 (13.5%) TR5 “highly suspicious.” Among our cohort, the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of the Thyroid Imaging Reporting and Data System was 71.4%, 38.1%, 40.2%, 69.6%, and 50.4%, respectively. Conclusion: Among cytologically indeterminate and Afirma-suspicious nodules, the Thyroid Imaging and Reporting and Data System was a poor predictor of final surgical pathology. Additional prospective studies are needed to validate these findings.

Original languageEnglish (US)
Pages (from-to)69-74
Number of pages6
JournalSurgery (United States)
Volume165
Issue number1
DOIs
StatePublished - Jan 2019

ASJC Scopus subject areas

  • Surgery

Fingerprint Dive into the research topics of 'The association between the ultrasonography TIRADS classification system and surgical pathology among indeterminate thyroid nodules'. Together they form a unique fingerprint.

Cite this