Thyroid imaging reporting and data system in assessment of cytological Bethesda Category III thyroid nodules

Article type: Research Article

Authors: Mao, Feng^{a; b; c} | Xu, Hui-Xiong^{a; c; d; *} | Zhao, Chong-Ke^{a; c; d} | Bo, Xiao-Wan^{a; c; d} | Li, Xiao-Long^{a; c; d} | Li, Dan-Dan^{a; c; d} | Liu, Bo-Ji^{a; c; d} | Zhang, Yi-Feng^{a; c; d} | Xu, Jun-Mei^{a; c; d} | Qu, Shen^{c; d; e}

Affiliations: [a] Department of Medical Ultrasound, Shanghai Tenth People’s Hospital, Ultrasound Research and Education Institute, Tongji University School of Medicine, Shanghai, China | [b] Department of Ultrasound, Ningbo First Hospital, Ningbo, China | [c] Thyroid Institute, Tongji University School of Medicine, Shanghai, China | [d] Shanghai Center for Thyroid Diseases, Shanghai, China | [e] Department of Endocrinology and Metabolism, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, China

Correspondence: [*] Corresponding author: Hui-Xiong Xu, Department of Medical Ultrasound, Shanghai Tenth People’s Hospital, Ultrasound Research and Education Institute, Tongji University School of Medicine, Shanghai 200072, China. Tel.: +86 21 66307539; Fax: +86 21 66301031 (O); E-mail: xuhuixiong@126.com.

Abstract: OBJECTIVE: To assess the usefulness of thyroid imaging reporting and data system (TI-RADS) for cytological Bethesda Category III thyroid nodules (TNs). METHODS: This retrospective study included 121 patients with 121 TNs classified as Bethesda Category III at fine needle aspiration (FNA) cytology and thereafter underwent surgery. The TNs were classified according to US TI-RADS category and the malignancy risk of each category was calculated. RESULTS: Surgical pathology confirmed 43 (35.5%) malignant and 78 (64.5%) benign TNs. The malignancy risks of categories 3, 4a, 4b, 4c, and 5 TNs were 0%, 4.0%, 12.5%, 62.2%, and 100%, respectively. For those >10 mm (n = 55), the malignancy risks were 0%, 6.2%, 12.5%, 73.3%, and 100%, respectively, whereas for those ≤10 mm (n = 66), the risks were 0%, 0%, 12.5%, 56.7%, and 100%, respectively. CONCLUSION: Bethesda Category III TNs without suspicious US features or those ≤10 mm with only one suspicious US feature can be followed up with US.

Keywords: Thyroid nodule, ultrasound, thyroid imaging reporting and data system, Bethesda Category III, AUS/FLUS

DOI: 10.3233/CH-16146

Journal: Clinical Hemorheology and Microcirculation, vol. 65, no. 2, pp. 163-173, 2017