ORIGINAL ARTICLE   

Minerva Endocrinology 2023 Apr 06

DOI: 10.23736/S2724-6507.22.03929-X

Copyright © 2022 EDIZIONI MINERVA MEDICA

language: English

ACR TI-RADS Score combined with cytopathology classification improves the risk stratification of indeterminate thyroid nodules

Francesco FEROCI ¹, Davina PERINI ¹, Alessio GIORDANO ¹ ✉, Luca ROMOLI ¹, Tommaso GUAGNI ¹, Angela COPPOLA ², Iacopo GIANI ¹, Serenella CHECCHI ³, Alvaro PETRUCCI ¹, Antonio SARNO ¹, Stefano CANTAFIO ¹

¹ Unit of General Surgery, Department of Surgery, Santo Stefano Hospital, Azienda ASL Toscana Centro, Prato, Italy; ² Unit of Nuclear Medicine, Santo Stefano Hospital, Azienda ASL Toscana Centro, Prato, Italy; ³ Endocrine Unit, Santo Stefano Hospital, Azienda ASL Toscana Centro, Prato, Italy

BACKGROUND: The aim of this retrospective study was the elaboration of a new diagnostic model that integrate cytological reports (2017 Bethesda System for Reporting Thyroid Cytopathology) with ultrasonographic features (based on ACR TI-RADS score) to achieve a more accurate definition of indeterminate thyroid nodule malignancy risk.
METHODS: Ninety patients submitted to thyroidectomy were divided in three classes: low malignancy risk (AUS/FLUS with TI-RADS 2/TI-RADS 3 and FN/SFN with TI-RADS 2), intermediate malignancy risk (AUS/FLUS with TI-RADS 4/TI-RADS 5 and FN/SFN with TI-RADS 3/TI-RADS 4), and high malignancy risk (FN/SFN with TI-RADS 5).
RESULTS: The surgical approach should be recommended in high-risk patients (81.82% of malignancies), carefully evaluated in intermediate risk (25.42%), whereas a conservative approach can be adopted in low-risk patients (0.00%).
CONCLUSIONS: The integration of these two multiparametric systems in a Cyto-US score has proven to be a feasible and reliable aid to achieve a more accurate definition of malignancy risk.

KEY WORDS: Thyroid neoplasms; Thyroid nodule; Cytology; Ultrasonography