Comparison of TI-RADS classification with FNAC for the Diagnosis of Thyroid Nodules

  • Naushaba Malik Head, Department of Radiology, PESSI Hospital, Islamabad, Pakistan
  • Maryam Rauf Consultant, Department of Radiology, PESSI Hospital, Islamabad, Pakistan
  • Ghazala Malik Radiologist, Pakistan Institute of Medical Sciences, Islamabad, Pakistan
Keywords: TI-RADS, Cytology, FNAC, Thyroid nodules


Background: Thyroid nodules are very common and its prevalence is largely dependent on the identification techniques. Recently high-resolution ultrasound thyroid imaging has paved the way for significant transformation in clinical approach to thyroid nodule. This study aimed to determine the efficacy of TI-RADS classification and its association with FNAC findings in thyroid lesions.

Material and Methods: This prospective study was carried out in the Department of Radiology of Islamabad Diagnostic Centre, Islamabad for a period of 6 months from 6th January 2018 to 6th July, 2018. All male and female patients presenting with thyroid nodules were selected for the study. Ultrasound neck was performed with high frequency linear probes. Ultrasonography findings were classified according to Thyroid Imaging Reporting and Data System (TI-RADS) classification, as defined by Horvath et al. Patients with TI-RADS II-V were scheduled for US-guided Fine Needle Aspiration (FNA). All the specimens were sent to pathology laboratory for cytology (FNAC).

Results: Total 123 patients of thyroid nodules were studied. Mean age of the patients was 45.78 ± 13.11 years, with a female predominance (73.2%). A significant association was seen between TI-RADS classification of thyroid nodules and findings on cytology. Thyroid nodules with TI-RADS II, III and IV a classification showed benign cytological findings, while TI-RADS class V had a significant association with malignant findings on cytology (P=0.001).

Conclusions: TI-RADS classification is a reliable modality in differentiating benign thyroid nodules from malignant ones and circumvent the need for FNAC in every case with a thyroid nodule.

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