CORRELATION BETWEEN THE THYROID IMAGE AND REPORTING DATA SYSTEM (TIRADS) AND THE BETHESDA SYSTEM FOR REPORTING THYROID CYTOPATHOLOGY IN PATIENTS WITH THYROID NODULES

Authors

  • Saba Shaheen Allama Iqbal Teaching Hospital Dera Ghazi Khan https://orcid.org/0009-0006-1065-6937
  • Uzma Shaheen Allama Iqbal Teaching Hospital Dera Ghazi Khan
  • Shamsul Hadi RHC Martung, Shangla https://orcid.org/0000-0003-2479-7002
  • Muhammad Umair Sir Ganga Ram Hospital, FJMU, Lahore
  • Naveed Qamar Peshawar Medical Complex Kernal Sher Khan, Swabi, KPK

DOI:

https://doi.org/10.70520/kjms.v18i3.704

Keywords:

Thyroid nodule, Fine needle aspiration biopsy, TIRADS scoring, Bethesda system

Abstract

Objective: To determine the correlation between the thyroid image and reporting data system (TIRADS) and the Bethesda system for reporting thyroid cytopathology in patients presenting with thyroid nodules.

Methods: This cross-sectional study was performed at the histopathology department of Allama Iqbal teaching hospital DG Khan, over six months. A total of 87 patients aged 18 to 60 years referred to the pathology department for FNAC of thyroid nodules were included. Exclusion criteria were prior thyroid cancer diagnosis, ongoing chemo / radiotherapy or recurrence. Demographic details laterality and TIRADS grading were recorded. Samples were stained with hematoxylin and eosin and assessed microscopically. Histopathology reporting followed the Bethesda system. Data were analyzed using SPSS version 23. Spearman’s correlation was used to evaluate TIRADS and Bethesda grades.

Results:  The mean participant age was 36.3 ± 10.7 years. Gender distribution was almost equal. Unilateral thyroid nodules were noted in 51.7% of the cases. TIRADS grading showed most nodules as grade 3 (40.2%) or grade 4 (39.1%). FNAC reported benign cytology (grade 2) in 72.4% and malignant (grade 6) in 11.5%. Malignancy was suspected in 48.3% by TIRADS and confirmed in 22.9% on histopathology. A weak but significant positive correlation existed between TIRADS and Bethesda grade (rs = 0.245, p = 0.022).

Conclusion: TIRADS showed a weak correlation to cytopathologic grading.

References

REFERENCES

1. Ouyang S, Li W, Yu P, Li H, Cai H, Wu J. Effect of Chinese herbal medicine for patients with benign thyroid nodules in adults: a protocol for systematic review and meta-analysis. Medicine. 2021;100(8):e24591. doi: 10.1097/MD.0000000000024591.

2. Vadhiraj VV, Simpkin A, O’Connell J, Singh Ospina N, Maraka S, O’Keeffe DT. Ultrasound image classification of thyroid nodules using machine learning techniques. Medicina. 2021;57(6):527. doi: 10.3390/medicina57060527.

3. Al-Hakami HA, Alqahtani R, Alahmadi A, Almutairi D, Algarni M, Alandejani T.

Thyroid nodule size and prediction of cancer: a study at tertiary care hospital in Saudi Arabia. Cureus. 2020;12(3):e7478. doi: 10.7759/cureus.7478.

4. Shayganfar A, Hashemi P, Esfahani MM, Ghanei AM, Moghadam NA, Ebrahimian S. Prediction of thyroid nodule malignancy using thyroid imaging reporting and data system (TIRADS) and nodule size. Clin Imaging. 2020;60(2):222-7. doi: 10.1016/j.clinimag.2019.10.004.

5. Dobruch-Sobczak K, Adamczewski Z, Dedecjus M, Lewi?ski A, Migda B, Rucha?a M, et al. Summary of meta-analyses of studies involving TIRADS classifications (EU-TIRADS, ACR-TIRADS, and K-TIRADS) in evaluating the malignant potential of focal lesions of the thyroid gland. J Ultrason. 2022;22(89):121-9. doi: 10.15557/JoU.2022.0020.

6. Mohan U, Sunny SP, Mendonca P, Kuriakose MA, Kannan S, Suresh A. Systematic review and meta-analysis to identify the immunocytochemical markers effective in delineating benign from malignant thyroid lesions in FNAC samples. Endocr Pathol. 2022;33(2):243-56. doi: 10.1007/s12022-022-09721-5.

7. Vuong HG, Chung DG, Ngo LM, Bui TQ, Hassell L, Jung CK, et al. The use of the Bethesda system for reporting thyroid cytopathology in pediatric thyroid nodules: a meta-analysis. Thyroid. 2021;31(8):1203-11. doi: 10.1089/thy.2020.0702.

8. Aksoy SH, Uygun O, Yurdaisik I, Ates L, Aydin S. The relationship between ultrasound-based TIRADS and BETHESDA categories in patients undergoing thyroid biopsy. Clin Exp Med. 2022;22(4):661-6. doi: 10.1007/s10238-021-00779-9.

9. Ghazi FN, Zain WZ, Yahya MM, Haron J, Rahman WF, Zakaria Z, et al. Correlation between the Thyroid Image and Reporting Data System (TIRADS) and the Bethesda System for Reporting the Thyroid Cytopathology in patients with thyroid nodules. 2023. Available from: https://www.researchsquare.com/article/rs-2502442/v1.pdf doi: 10.21203/rs.3.rs-2502442/v1.

10. Dhar L, Singh M, Jain SL, Rana D, Kumar J, Meher R, et al. Correlation of ultrasound?based TIRADS and the Bethesda system for reporting of thyroid cytopathology: a study in a tertiary care centre. Cytopathology. 2023;34(6):590-6. doi: 10.1111/cyt.13273.

11. Alshaikh R, Almaghribi K, Alshammari DM, Mohamad H, Ebrahim W, Alshammari SM, et al. Correlation between ultrasound and cytological findings of patients with suspicious thyroid nodules: the King Hamad University Hospital experience. Cureus. 2022;14(3):e22877. doi: 10.7759/cureus.22877.

12. Grimmichova T, Pacesova P, Hill M, Pekova B, Vankova M, Moravcova J, et al. Thyroid cancer detection in a routine clinical setting: performance of ACR TI-RADS, FNAC, and molecular testing in prospective cohort study. Biomedicines. 2022;10(5):954. doi: 10.3390/biomedicines10050954.

13. Sgrò D, Brancatella A, Greco G, Torregrossa L, Piaggi P, Viola N, et al. Cytological and ultrasound features of thyroid nodules correlate with histotypes and variants of thyroid carcinoma. J Clin Endocrinol Metab. 2023;108(11):e1186-92. doi: 10.1210/clinem/dgad313.

14. Chen Q, Lin M, Wu S. Validating and comparing C-TIRADS, K-TIRADS and ACR-TIRADS in stratifying the malignancy risk of thyroid nodules. Front Endocrinol. 2022;13:899575. doi: 10.3389/fendo.2022.899575.

15. Liang F, Li X, Ji Q, He D, Yang M, Xu Z. Revised Thyroid Imaging Reporting and Data System (TIRADS): imitating the American College of Radiology TIRADS, a single-center retrospective study. Quant Imaging Med Surg. 2023;13(6):3862-72. doi: 10.21037/qims-22-1307.

16. Han M, Fan F. Bethesda system for reporting thyroid cytopathology–an updated review. J Clin Transl Pathol. 2023;3(2):84-98. doi: 10.14218/JCTP.2023.00005.

17. Wahid FI, Khan SF, Rehman HU, Khan IA. Role of fine needle aspiration cytology in diagnosis of solitary thyroid nodules. Iran J Otorhinolaryngol. 2011;23(4):111-8. doi: 10.22038/ijorl.2011.220.

18. Periakaruppan G, Seshadri KG, Vignesh Krishna G, Mandava R, Rajendiran VS. Correlation between ultrasound–based TIRADS and Bethesda system for reporting thyroid–cytopathology: 2–year experience at a tertiary care center in India. Ind J Endocr Metab. 2018;22(5):651–5. doi: 10.4103/ijem.IJEM_27_18.

19. Atar C, Dalc? K, Aktar Y, Totik N, Topal U, Eray ?C, et al. Correlation of TIRADS scoring in thyroid nodules with preoperative fine needle aspiration biopsy and postoperative specimen pathology. Head Neck. 2024;46(4):849-56. doi: 10.1002/hed.27622.

20. George NA, Suresh S, Jiji V, Renu S, Thomas S, Janardhan D, et al. Correlation of TIRADS and Bethesda scoring systems with final histopathology of thyroid nodules–an institutional experience. Indian J Otolaryngol Head Neck Surg. 2022;74(Suppl 3):5753-8. doi: 10.1007/s12070-021-02380-8.

21. Huang EY, Kao NH, Lin SY, Jang IJ, Kiong KL, See A, et al. Concordance of the ACR TI-RADS classification with Bethesda scoring and histopathology risk stratification of thyroid nodules. JAMA Netw Open. 2023;6(9):e2331612. doi: 10.1001/jamanetworkopen.2023.31612.

22. Singaporewalla RM, Hwee J, Lang TU, Desai V. Clinico-pathological correlation of thyroid nodule ultrasound and cytology using the TIRADS and Bethesda classi cations. World J Surg. 2017;41(7):1807–11. doi: 10.1007/s00268-017-3919-5.

23. Jo VY, Stelow EB, Dustin SM, Hanley KZ. Malignancy risk for ne-needle aspiration of thyroid lesions according to the Bethesda system for reporting thyroid cytopathology. Am J Clin Pathol. 2010;134(3):450–6. doi: 10.1309/AJCP5N4MTHPAFXFB.

24. Bongiovanni M, Spitale A, Faquin WC, Mazzucchelli L, Baloch ZW. The Bethesda system for reporting thyroid cytopathology: a meta-analysis. Acta Cytol. 2012;56(4):333–9. doi: 10.1159/000339959.

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Published

2025-09-30

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1.
Shaheen S, Shaheen U, Hadi S, Umair M, Qamar N. CORRELATION BETWEEN THE THYROID IMAGE AND REPORTING DATA SYSTEM (TIRADS) AND THE BETHESDA SYSTEM FOR REPORTING THYROID CYTOPATHOLOGY IN PATIENTS WITH THYROID NODULES. KJMS [Internet]. 2025 Sep. 30 [cited 2025 Nov. 14];18(3):237-42. Available from: https://kjms.com.pk/index.php/kjms/article/view/704

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