Preoperative Evaluation of Thyroid Nodules: A Prospective Study Comparing the accuracy of Ultrasound (TI-RADS) Versus the FNAC Bethesda System in Relation to the Final Postoperative Histo-pathological Diagnosis

Objectives: We are trying to improve and detect the accuracy of the diagnostic tools of thyroid nodules by comparing the findings of thyroid ultrasound (US) using the thyroid image reporting and data system (TI-RADS) with the results of fine needle aspiration cytology (FNAC) that were reported according to the Bethesda system for reporting thyroid Cytopathology (TBSRTC), through matching the results of both maneuverswith the final postoperative (PO)pathology reports. Methods:The study included 100 patients suffering from thyroid swelling.Patients underwent ultrasound assessment using TI-RADS and FNAC biopsy using TBSRTCand then, all patients underwent thyroidectomy operation. Specimens sent to a laboratory for histological examination. The results of TI-RADS compared with Bethesda categories, and then both results were matched with the final histology reports. Data collected and statisticallyanalyzed. Results: The overall concordance rate between US TI-RADS and TBSRTC is 67.6%. (82% in benign cases, 70.9%, in indeterminate cases, 50% in malignant cases). The overall concordance rate of results of TI-RADS versus FNAC with the final PO pathological results for predicting malignancy were(75.4%, 81.8%)with a sensitivity of (76.9 %, 81.8%) and specificity of (91.3%,98%), positive predictive valueswere (PPV)(71.4%,90%), and negative predictive values were (NPV)(76.4%, 96%), respectively. Conclusion: TI-RADS and TBSRTC classification systems could be considered as feasible and effective diagnosticmodalities for predicting malignant lesions in patients had thyroid nodules. It's important for the clinicians to implement these diagnostic tests to improve their clinical performance and surgical outcomes.