CORRELATION OF TIRADS [THYROID IMAGING REPORTING AND DATA SYSTEM] AND HISTOPATHOLOGICAL FINDINGS IN EVALUATION OF THYROID NODULES.

Purpose: Ultrasound [US] is an excellent noninvasive modality to evaluate thyroid nodules.Aim of our study was to characterize the thyroid nodules according to grey scale sonographic features into high suspicious ,probably benign, benign aspects and normal thyroid using TIRADS scoring system and to characterize the thyroid nodule according to the sonographic features into a specific TIRADS stage and correlate the results with the histopathological examination findings wherever possible. Material And Methods: The prospective study was carried out on 60 patients referred to Department of Radiodiagnosis, Rajindra Hospital,Patiala. All the patients were subjected to detailed history taking,clinical examination and routine laboratory investigations.All thyroid nodules were characterized according to the internal component[solid, mixed or cystic], the margins, echogenicity [hyperechoic, Isoechoic,hypoechoic, marked hypoehoic], evidence of calcification [microcalcification if less than 3mm and macrocalcification if more than 3mm with acoustic shadowing]and the shape[taller than wide if greater in anteroposterior dimension than in its transverse dimension and wider than tall]. Using the Modified Russ Classification, each nodule was classified into TIRADS categories [1,2,3,4A,4B and 5] based on ultrasound features.The patients were referred to Department of Pathology, Government Medical College Patiala and FNAC was done. The US findings were correlated with FNAC and data was analyzed statistically. Results: Based on various ultrasound characteristics of thyroid nodules,TIRADS score was given to each thyroid nodule and then FNAC was done.The results of histopathology were correlated with ultrasound features and statistical analysis was done calculating sensitivity, specificity,positive predictive value and negative predictive value for each feature.The sensitivity and specificity for Irregular contours were 44.4% and 94.12%,for taller than wide were 22.22% and 100%,for microcalcification were33.3.3% and 94.12%,for marked hypoechogenicity was 78 and 70.89% and for solid consistency were89 and 70.5%.The risk of malignancy was found to increase from TIRADS3 to TIRADS5 in this study. All the cases [100%] of TIRADS 5 turned out to be malignant on histopathology. Conclusion: Radiologists should be aware of usefulness of specific ultrasound features of thyroid nodules like Irregular contours, taller than wide configuration, microcalcification, marked hypoechogenicity and solid consistency collectively taken as TIRADS for better differentiation of benign from malignant or potentially malignant lesions that warrant further diagnostic evaluation. The risk of malignancy was found to increase from TIRADS 3 to TIRADS 5 when different TIRADS categories were confronted with results of pathology and risk of malignancy was calculated.