[Home ] [Archive]   [ فارسی ]  
:: Main :: About :: Current Issue :: Archive :: Search :: Submit :: Contact ::
Main Menu
Home::
Journal Information::
About the Journal
Aim and Scope
Content Coverage
Ethics
Conflict of Interest
Copyrights & License
Price
Indexing Sources::
Editorial Board::
Executive Members::
Articles Archive::
Current Issue
All Issues
Instruction to Authors::
Peer-Review::
Contact Us::
Contact Us
Contact Form
Site Facilities::
Search contents
::
Search in website

Advanced Search
Receive site information
Enter your Email in the following box to receive the site news and information.
:: Volume 22, Issue 3 (10-2020) ::
J Gorgan Univ Med Sci 2020, 22(3): 106-112 Back to browse issues page
Agreement between thyroid nodules ultrasound and cytology of fine needle aspiration (FNA) based on TIRADS and Bethesda system
Somayeh Livani 1, Esmaeel Naeimi2 , Nemat Taghavi3
1- Radiologist, Assistant Professor, Clinical Research Development Center (CRDC), Sayad Shirazi Hospital, Golestan University of Medical Sciences, Gorgan, Iran , dr_slivani@yahoo.com
2- Pathologist, Faculty of Medicine, Golestan University of Medical Sciences, Gorgan, Iran
3- Radiologist, Faculty of Medicine, Golestan University of Medical Sciences, Gorgan, Iran
Abstract:   (19192 Views)
Background and Objective: Thyroid nodules are common among the general population and they increase the risk of thyroid malignancies. This study was done to evaluate the correlation of findings of ultrasound based on Thyroid Imaging and Reporting Data System (TIRADS) and cytology of fine needle aspiration (FNA) based on Bethesda system to evaluate of thyroid nodules.
Methods: This descriptive-analytical study, was performed on 165 patients (152 females and 13 males) referred to the sonography center of Sayyad Shirazi Educational Hospital, Gorgan, northern Iran during 2018. Ultralosonographic features of nodules were recorded in the pre-filled checklist. According to TIRADS and endocrinologist clinical suspicion, couple of patients was eligible for FNA under the ultrasound guidance. The cytology of FNAs was reported based on the Bethesda system classification.
Results: The mean age was significantly lower in patients with malignant nodules (35.4 vs 44.8; P<0.05). Frequency of malignancy was 8 times higher among females than males (16 vs. 2). TIRADS 3 and 4 were the most common categories among the others with the prevalence of 44.4% and 32.3%, respectively. Bethesda 2 and 4 were the most prevalent categories with prevalence of 58.8% and 20.6%, respectively. The strongest agreement was observed between TIRADS 2 and Bethesda 2 that showed benign findings. Kappa index was 0.061 between TIRADS and Bethesda (P<0.05). Echogenicity, echogenic foci, shape, and margin of nodules were seen significantly more in malignancy.
Conclusion: The most accurate prediction of TIRADS belongs to benign nodules. The correlation between TIRADS and Bethesda was evaluated to be significant overall and the maximum level of correlation was at benign findings. Therefore, these two systems can efficiently be used in order to rule out malignancies and reduce the rate of invasive interventions.
Keywords: Thyroid Nodule [MeSH], Thyroid Neoplasms [MeSH], Ultrasonography [MeSH], Fine Needle Aspiration [MeSH], TIRADS , Bethesda System
Article ID: Vol22-44
Full-Text [PDF 284 kb]   (10670 Downloads)    
Type of Study: Original Articles | Subject: Radiology
References
1. Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018 Nov; 68(6): 394-424. DOI: 10.3322/caac.21492
2. Vargas-Uricoechea H, Meza-Cabrera I, Herrera-Chaparro J. Concordance between the TIRADS ultrasound criteria and the BETHESDA cytology criteria on the nontoxic thyroid nodule. Thyroid Res. 2017 Feb; 10:1. DOI: 10.1186/s13044-017-0037-2
3. Horvath E, Silva CF, Majlis S, Rodriguez I, SkoknicV, Castro A, et al. Prospective validation of the ultrasound based TIRADS (Thyroid Imaging Reporting And Data System) classification: results in surgically resected thyroid nodules. Eur Radiol. 2017 Jun; 27(6): 2619-28. DOI: 10.1007/s00330-016-4605-y
4. Bray F, Colombet M, Mery L, Piñeros M, Znaor A, Zanetti R, et al. Cancer Incidence in Five Continents, Vol. XI (electronic version). Lyon: International Agency for Research on Cancer. 2017. Available from: https://ci5.iarc.fr, accessed [2020]
5. Haugen BR, Alexander EK, Bible KC, Doherty GM, Mandel SJ, Nikiforov YE, et al. 2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer: The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer. Thyroid. 2016 Jan; 26(1): 1-133. DOI: 10.1089/thy.2015.0020
6. Guth S, Theune U, Aberle J, Galach A, Bamberger CM. Very high prevalence of thyroid nodules detected by high frequency (13 MHz) ultrasound examination. Eur J Clin Invest. 2009; 39(8): 699-706. DOI: 10.1111/j.1365-2362.2009.02162.x
7. Singaporewalla RM, Hwee J, Lang TU, Desai V. Clinico-pathological correlation of thyroid nodule ultrasound and cytology using the TIRADS and Bethesda classifications. World J Surg. 2017 Jul; 41(7): 1807-11. DOI: 10.1007/s00268-017-3919-5
8. Yu Q, Jiang T, Zhou A, Zhang L, Zhang C, Xu P. Computer-aided diagnosis of malignant or benign thyroidnodes based on ultrasound images. Eur Arch Otorhinolaryngol. 2017 Jul; 274(7): 2891-97. DOI:10.1007/s00405-017-4562-3
9. Baser H, Cakir B, Topaloglu O, Alkan A, Polat SB, Dogan HT, et al. Diagnostic accuracy of Thyroid Imaging Reporting and Data System in the prediction of malignancy in nodules with atypia and follicular lesion of undetermined significance cytologies. Clin Endocrinol (Oxf). 2017 Apr; 86(4): 584-90. DOI: 10.1111/cen.13274
10. Srinivas MNS, Amogh V, Gautam MS, Prathyusha IS, Vikram N, Retnam MK, et al. A prospective study to evaluate thereliability of thyroid imaging reporting and data system in differentiation between benign and malignant thyroid lesions. J Clin Imaging Sci. 2016; 6: 5. DOI: 10.4103/2156-7514.177551
11. Dietrich CF, Mueller T, Bojunga J, Dong Y, Mauri G, Radzina M, et al. Statement andrecommendations on interventional ultrasound as a thyroid diagnostic and treatment procedure. Ultrasound Med Biol. 2018 Jan; 44(1): 14-36. DOI: 10.1016/j.ultrasmedbio.2017.08.1889
12. Moon HJ, Kim EK, Kwak JY. Malignancy risk stratification in thyroid nodules with benign results on cytology: combination of thyroid imaging reporting and data system and Bethesda system. Ann Surg Oncol. 2014 Jun; 21(6): 1898-903. DOI: 10.1245/s10434-014-3556-2
13. Yoon JH, Kwon HJ, Kim EK, Moon HJ, Kwak JY. Subcategorization of atypia of undetermined significance/follicular lesion of undetermined significance (AUS/FLUS): a study applying Thyroid Imaging Reporting and Data System (TIRADS). Clin Endocrinol (Oxf). 2016 Aug; 85(2): 275-82. DOI: 10.1111/cen.12987
14. Yoon JH, Lee HS, Kim EK, Moon HJ, Kwak JY. Thyroid Nodules: Nondiagnostic Cytologic Results according to Thyroid Imaging Reporting and Data System before and after Application of the Bethesda System. Radiology. 2015 Aug; 276(2): 579-87. DOI: 10.1148/radiol.15142308
15. Liu X, Medici M, Kwong N, Angell TE, Marqusee E, Kim MI, et al. Bethesda categorization of thyroid nodule cytologyand prediction of thyroid cancer type and prognosis. Thyroid. 2016 Feb; 26(2): 256-61. DOI: 10.1089/thy.2015.0376
16. Cibas ES, Ali SZ. The 2017 Bethesda system for reporting thyroid cytopathology. Thyroid. 2017 Nov; 27(11): 1341-46. DOI: 10.1089/thy.2017.0500
17. Kwak JY, Han KH, Yoon JH, Moon HJ, Son EJ, Park SH, et al. Thyroid imaging reporting and data system for US features of nodules: a step in establishing better stratification of cancer risk. Radiology. 2011 Sep; 260(3): 892-99. DOI: 10.1148/radiol.11110206
18. Afshar Moghadam N, Kachouei A. [Comparision of the Diagnostic values of Doppler Sonography with Fine Needle Aspiration in Thyroid Nodules]. Endocrin Metabol (IJEM). 2005; 7(1): 31-36. [Article in Persian]
19. Park JY, Lee HJ, Jang HW, Kim HK, Yi JH, Lee W, et al. A proposal for a thyroid imaging reporting and datasystem for ultrasound features of thyroid carcinoma. Thyroid. 2009 Nov; 19(11): 1257-64. DOI: 10.1089/thy.2008.0021
20. Tessler FN, Middleton WD, Grant EG, Hoang JK, Berland LL, Teefey SA, et al. ACR thyroid imaging, reporting and data system (TI-RADS): white paper of the ACR TI-RADS committee. J Am Coll Radiol. 2017 May; 14(5): 587-95. DOI: 10.1016/j.jacr.2017.01.046
21. Liu Z, Huang T. Papillary thyroid microcarcinoma: an over-treated malignancy? World J Surg. 2016 Mar; 40(3): 764-65. DOI: 10.1007/s00268-015-3244-9
22. Tan H, Li Z, Li N, Qian J, Fan F, Zhong H, et al. Thyroid imaging reporting and data system combined with Bethesda classification in qualitative thyroid nodule diagnosis. Medicine (Baltimore). 2019 Dec; 98(50): e18320. DOI: 10.1097/MD.0000000000018320
23. Shayganfar A, Hashemi P, Masjedi Esfahani M, Ghanei AM, Afshar Moghadam N, Ebrahimian S. Prediction of thyroid nodule malignancy using thyroid imaging reporting and data system (TIRADS) and nodule size. Clinical Imaging. 2020 Apr; 60(2): 222-27. https://doi.org/10.1016/j.clinimag.2019.10.004
24. Figge JJ. Epidemiology of thyroid cancer. In: Wartofsky L, Van Nostrand D. Thyroid Cancer: A Comprehensive Guide to Clinical Management. Springer. 2016; pp: 9-15.
25. Bessey LJ, Lai NBK, Coorough NE, Chen H, Sippel RS. The incidence of thyroid cancer by f ine needle aspiration varies by age and gender. J Surg Res. 2013 Oct; 184(2): 761-65. DOI: 10.1016/j.jss.2013.03.086
26. Rago T, Fiore E, Scutari M, Santini F, Di Coscio G, Romani R, et al. Male sex, single nodularity, and young age are associated with the risk of finding a papillary thyroid cancer on fine-needle aspiration cytology in a large series of patients with nodular thyroid disease. Eur J Endocrinol. 2010 Apr; 162(4): 763-70. DOI: 10.1530/EJE-09-0895
27. Mittendorf EA, Khiyami A, McHenry CR. When fine-needle aspiration biopsy cannot exclude papillary thyroid cancer: a therapeutic dilemma. Arch Surg. 2006 Oct; 141(10): 961-66. DOI: 10.1001/archsurg.141.10.961
28. Preston-Martin S, Franceschi S, Ron E, Negri E. Thyroid cancer pooled analysis from 14 case-control studies: what have we learned? Cancer Causes Control. 2003 Oct; 14(8): 787-89. DOI: 10.1023/a:1026312203045
29. Imran SA, Rajaraman M. Management of differentiated thyroid cancer in pregnancy. J Thyroid Res. 2011; 2011: 549609. DOI: 10.4061/2011/549609
Send email to the article author

XML   Persian Abstract   Print

Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
Livani S, Naeimi E, Taghavi N. Agreement between thyroid nodules ultrasound and cytology of fine needle aspiration (FNA) based on TIRADS and Bethesda system. J Gorgan Univ Med Sci 2020; 22 (3) :106-112
URL: http://goums.ac.ir/journal/article-1-3622-en.html
Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Volume 22, Issue 3 (10-2020) Back to browse issues page
مجله دانشگاه علوم پزشکی گرگان Journal of Gorgan University of Medical Sciences
Persian site map - English site map - Created in 0.06 seconds with 36 queries by YEKTAWEB 4645