Comparative Study of Thyroid Cytology Using Bethesda System with Radiological Grading (Tirad Score)

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Dr. Vaswati Das, Dr. Sutapa Chowdhuri, Dr. Soham Basu, Dr. Himangshu Mahato


Background: High-resolution (HR) ultrasound imaging of the thyroid has transformed how thyroid nodules (TN) are treated in a big way. In thyroid imaging, risk categorization systems aim to reduce interobserver variability and improve communication. The categories provided by the "Thyroid Image Reporting and Data System" (TIRADS) seem to be the most relevant. The Bethesda as well as TIRADS methods for describing "thyroid cytopathology" are compared in this research using HR ultrasonography on Indian TN.

Materials and Methods: Respondents in this exploratory trial comprised 195, all of whom had been diagnosed with a TN using B-mode ultrasound and were planned to have "fine-needle aspiration cytology (FNAC)". During the duration of follow-up, a Bethesda categorization tabulation is carried out in parallel on each of these nodules. By correlating these outcomes, precision, cross-tabulation, positive predictive value (PPV), as well as Chi square tests are used to figure out how well TIRADS can tell the difference between benign as well as cancerous nodules.

Results: 116 TIRADS II two nodules were evaluated, and none were found to be Bethesda IV or above, indicating that they were all malignant. TIRADS II, TIRADS III, TIRADS IV A & B, as well as TIRADS V all had zero percent, 2.2 percent, 38.5 percent, 52.5 percent, as well as 77.8 percent malignancy risk. The percentage of people who are at risk of developing cancer according to this research is similar to that observed in previous noteworthy studies.

Conclusion: The TIRADS system, which is built on ultrasound technology, has the potential to predict with a specific degree of precision the possibility that a specific nodule contains cancerous cells. In light of the results and other analyses of the relevant literature, it is reasonable to hypothesise that FNAC can be avoided or, at the very least, rescheduled in the vast majority of newly identified instances containing TIRADS II nodules. In this study, the findings indicate that there is a remarkable degree of concordance between the TIRADS ultrasonography classification as well as the Bethesda cytology (BC), primarily for the benign nodules.

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