Thyroid imaging reporting and data system score: evaluation of risk stratification in thyroid nodules with Hashimoto’s Thyroiditis and thyroid nodules without Hashimoto’s thyroiditis underwent fine-needle aspiration cytology: results from a prospective study.

Pani F

;Boi F;Satta C;Serafini C;Casula S;Arisci N;Maurelli I;Lai ML;Mariotti S.

2016-01-01

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Abstract

BACKGROUND: Thyroid imaging reporting and data system (TI-RADS) was designed to better select thyroid nodules (TN) to fine needle aspiration cytology (FNAC) with high sensitivity and accuracy. However, the comparison of TI-RADS scores in TN with Hashimoto’s thyroiditis (HT) (HTN+) versus TN without HT (HTN-) has not been examined so far. The aim of this study was to compare the diagnostic performance of TI-RADS score in TN associated or not associated to HT. METHODS: 308 unselected TN consecutively submitted to FNAC from June 2014 to March 2015 were included to compare the diagnostic performance of TI-RADS score in HTN+ and in HTN–; individual TI-RADS score was correlated to FNAC categories in all cases. All suspicious ultrasound features (hypoechogenicity, microcalcifications, irregular margins, taller-thanwide shape, central vascularization) of TN were classified according French TI-RADS categories using a risk score of malignancy. RESULTS: HTN+ had higher prevalence of suspicious/malignant cytology (Tir 4-5) (HTN+ 48/121 = 40%) compared to HTN– (40/163 = 29%, p < 0.05). The distribution of all TI-RADS categories (from 2 to 5) in HTN+ was not significantly different from that found in HTN– (Table). At difference with TI-RADS, the individual features of hypoechogenicity and irregular margins had higher prevalence in HTN+ (77/121 64%) than in HTN– (58/157 37%, p < 0.001), and were more present in suspicious/malignant cytology (TIR 4-5) (69/88 78%) than in benign (Tir 2) cytology (25/196 13%, p < 0.0001). CONCLUSIONS: This study confirms our previous observation of higher prevalence of malignant FNAC in nodules associated to HT. TI-RADS score appears not significantly influenced by presence of HT, in spite of the higher prevalence in HTN+ of individual suspicious ultrasound features such as hypoechogenicity and irregular margins and may be proposed as an useful diagnostic tool to select nodules for FNA independently from associated HT.