ULTRASONOGRAPHIC EVALUATION OF THYROID NODULES BASED ON THYROID IMAGING REPORTING AND DATA SYSTEM (TI-RADS) AND CORRELATION WITH HISTOPATHOLOGY/ CYTOPATHOLOGY.

Background The detection of thyroid nodules has recently increased due to widespread use of ultrasonography. The main concern in the evaluation of thyroid nodules is the detection of malignancy. Ultrasonography is a widely accepted imaging modality for the initial assessment of thyroid nodules and helps in differentiating benign from malignant nodules. FNAC is considered as a reliable and effective method in differentiating benign and malignant nodules. Thyroid nodules show a highly diverse pattern on ultrasonography and there is an overlap between the ultrasound features of various thyroid lesions which causes difculty in classication of these nodules into benign and malignant categories. There is lack of a unied system to classify thyroid lesions clearly into benign and malignant categories. Horvath et al proposed an evaluation system for thyroid nodules called TIRADS (Thyroid Imaging Reporting and Data System). Objectives 1. To evaluate thyroid nodules using B-Mode and color Doppler ultrasound. 2. To classify these nodules based on TIRADS. 3. To correlate the ndings of ultrasound with ne needle aspiration cytology / histopathology. Materials and methods Patients who were referred to department of radiodiagnosis for USG investigation of thyroid in Pacic Institute of Medical Sciences, Udaipur, Rajasthan, over the time period from 1st March, 2021 to 30th September, 022.Thyroid nodules were evaluated for various ultrasound features and categorized using the TIRADS. These ndings were correlated with histopathology/ cytopathology ndings. Results Out of 118 patients, 101 were benign and 17 nodules were malignant. The nodules were evaluated for ultrasound features like hypo echogenicity, lobulated or poorly dened margins, micro calcications, taller than wider shape, central or predominant, central pattern of vascularity and solid composition; which showed a statistically signicant association with malignancy (p<0.05). The TIRADS classication has high sensitivity, specicity, and diagnostic accuracy in differentiating benign and malignant thyroid nodules. The risk of malignancy in our study for the TIRADS categories 2, 3, 4A, 4B, 4C and 5 were 0%, 1.5%, 4.8%, 63%, 100% and 100% respectively. Conclusion B mode ultrasound with colour Doppler is the most sensitive and specic imaging modality for initial assessment of thyroid nodules. Using ultrasound; TIRADS helps in differentiating benign and malignant thyroid nodules and standardizes the evaluation of thyroid nodules.