Concordance of the TI-RADS classification and the Bethesda System to detect malignancy in patients with thyroid nodule
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Abstract
Introduction: Evaluate the concordance of the TI-RADS classification and the
Bethesda system to detect malignancy in patients with a thyroid nodule. Material
and Methods: Through an observational, retrospective and cross-sectional study
in 90 patients with a diagnosis of thyroid nodule, to which neck ultrasound was
performed, definitive histopathological study and the TI-RADS (Thyroid Imaging
Reporting and Data System) and Bethesda scales were applied during their approach
from July 2018 to November 2020. Results: obtaining as a result, a predominance
of the female sex, a sensitivity of 43.6% and specificity of 94.2% in classification of
TI-RADS. Regarding the Bethesda classification, we obtained a sensitivity of 94.5%
and a specificity of 51.4%. With a low agreement as a result between the two tests.
Discussion: according to the results obtained in our study, we could verify that patients
with thyroid nodules benefit from an appropriate approach that includes a neck
Doppler USG, performed by a trained professional, in addition to the realization of
a Fine Needle Aspiration Biopsy (FNA) in the cases in which they are well indicated.
The concordance test was low; therefore, we consider it necessary to use both
diagnostic tests within clinical practice. Conclusion: the correct use of the TI-RADS
classification to identify the characteristics of a thyroid nodule allows reliable differentiation
to patients to undergo a FNA of those who do not require it. The Bethesda
system can support decision making or change therapeutic behavior, especially in
patients with high suspicion of malignancy.
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ISSN: 0120-8411
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