Avoidance of unnecessary fine-needle aspiration with the use of the Thyroid Imaging Reporting Data System classification and strain elastography based on The Bethesda System for Reporting Thyroid Cytopathology

Abstract

Thyroid fine-needle aspiration (FNA) biopsy has been widely accepted as an accurate and cost-effective tool in the management of thyroid nodules. To avoid unnecessary FNAs and provide appropriate management, patient evaluation should be based on a multidisciplinary approach. For this purpose, the Thyroid Imaging Reporting and Data System (TI-RADS) and strain elastography (SE) were proposed as tools for the risk assessment of malignancy in thyroid nodules. The aim of the present study was to analyze the utility of TI-RADS system and SE, along with FNA, and prospectively evaluate 369 consecutive patients referred for FNA of a thyroid nodule. TI-RADS was tested against The Bethesda System for Reporting Thyroid Cytopathology to determine whether there was an agreement between the two classification systemsstatistically, some agreement was observed. Medians of the maximum SE values (E-max) were obtained for benign and malignant FNA results and found to be 1.97 {[}interquartile range (IQR): 1.87] and 2.8 (IQR: 3.42), respectively (P=0.004). The number of studies investigating the utility of TI-RADS and SE along with TBSRCT is currently limited. Our study demonstrated that a multidisciplinary approach with the use of TI-RADS and SE may mildly improve the management of thyroid nodules.