Author(s)
Kelvin Anderson, BS
Adam Abbas, BS
Kia Jones, MD
Kimberly Wooten, MD
Ayham Al-Afif, MD
Vishal Gupta, MD
Affiliation(s)
Roswell Park Comprehensive Cancer Center; Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo;
Abstract:
Educational Objective: At the conclusion of this presentation, the participants should be able to determine the predictive value of TI-RADS score relative to core needle biopsy in thyroid nodule assessment.
Objectives: Advancements in imaging and histopathology have allowed for improved triaging of thyroid nodules. The American College of Radiology has proposed the Thyroid Imaging and Reporting and Data System (TI-RADS) for scoring ultrasound characteristics of thyroid nodules. Core needle biopsy (CNB) has emerged as a highly sensitive means of describing thyroid nodules and guiding treatment planning. The Korean Endocrine Society (KES) has developed a grading system to evaluate CNB. We sought to determine how well ultrasound derived TI-RADS scores relate to CNB pathology and KES grades.
Study Design: A retrospective chart review was performed for all patients seen in our department with thyroid pathology from 2020-2022.
Methods: We identified 94 patients (111 nodules) that received TI-RADS score followed by CNB. KES grades were assigned from pathological descriptions by trained head and neck physicians in a TI-RADS blinded manner. Data were analyzed using Spearman correlation and Pearson chi square tests with statistical significance at P<0.05.
Results: Nodules analyzed covered the full range of TI-RADS scores and CNB diagnoses, with clusters of hyperplastic and malignant nodules. TI-RADs scores strongly correlated with KES grades, and TI-RADs was useful in predicting need for further investigation. We will report diagnostic characteristics of TI-RADS relative to CNB.
Conclusions: In our practice, TI-RADS scores and tumor size, along with clinical presentation, guide biopsy recommendations. Retrospective analysis suggests that ultrasound evaluation with TI-RADS is highly reliable and can minimize unnecessary biopsies. Future studies will examine the correlation of specific ultrasound characteristics with CNB and surgical pathology to further define the screening value of TI-RADS.