Department of Pathology, New York University Langone Medical Center, New York, New York.
Department of Radiology, New York University Langone Medical Center, New York, New York.
Cancer Cytopathol. 2020 Jul;128(7):470-481. doi: 10.1002/cncy.22254. Epub 2020 Feb 20.
Ultrasound has become the initial approach to evaluating thyroid nodules, facilitating the distinction between benign and malignant nodules based on composition, echogenicity, nodule border or margin, shape, the presence of calcifications, and nodule dimensions. The American College of Radiology (ACR) recommended the Thyroid Imaging Reporting and Data System (TI-RADS) as a classification system to standardize thyroid ultrasound reports and to predict the probability of malignancy in thyroid nodules using a scoring system (TR1-TR5) based on multiple ultrasound characteristics and nodule size. Fine-needle aspiration (FNA) is recommended as the next step for nodules that warrant further workup. The authors assessed the accuracy of the ACR TI-RADS based on the corresponding FNA cytology results (Bethesda system diagnoses I-VI).
ACR TI-RADS ultrasound reports and corresponding FNA cytology diagnoses from January 1, 2018 to August 30, 2018 were evaluated.
From January 1, 2018 to August 30, 2018, 2306 thyroid ultrasound-guided FNAs were performed at our institution. Of 2306 cases, 361 had ACR TI-RADS reports available. The majority of FNAs were TR4 (180; 49.9%) or TR3 (108; 29.9%). No TR2 or TR3 nodules were associated with Bethesda category V or VI diagnoses. The majority of TR4 nodules (142 of 180; 78.9%) and TR5 nodules (42 of 65; 64.6%) exhibited benign (Bethesda category II) cytology. Fourteen TR5 cases (21.5%) had malignant (Bethesda category VI) cytology.
Although there were no TR2 or TR3 malignant (Bethesda category VI) diagnoses, and there were only a few malignancies in the TR4 and TR5 categories, the current results reassert the notion that the ACR TI-RADS scoring system shows at least some correlation between benign or malignant cytology diagnoses, as illustrated by the greater number of malignant cases in the higher ACR TI-RADS categories.
超声已成为评估甲状腺结节的初始方法，根据组成、回声特性、结节边界或边缘、形状、有无钙化以及结节大小，有助于区分良性和恶性结节。美国放射学院 (ACR) 推荐甲状腺影像报告和数据系统 (TI-RADS) 作为分类系统，以标准化甲状腺超声报告，并使用基于多种超声特征和结节大小的评分系统 (TR1-TR5) 预测甲状腺结节的恶性概率。对于需要进一步检查的结节，建议进行细针抽吸 (FNA)。作者评估了基于相应的细针抽吸细胞学结果 (Bethesda 系统诊断 I-VI) 的 ACR TI-RADS 的准确性。
评估了 2018 年 1 月 1 日至 2018 年 8 月 30 日的 ACR TI-RADS 超声报告和相应的细针抽吸细胞学诊断。
2018 年 1 月 1 日至 2018 年 8 月 30 日，我院进行了 2306 例甲状腺超声引导下的细针抽吸术。在 2306 例病例中，有 361 例有 ACR TI-RADS 报告。大多数细针抽吸术为 TR4(180;49.9%)或 TR3(108;29.9%)。没有 TR2 或 TR3 结节与 Bethesda 类别 V 或 VI 诊断相关。大多数 TR4 结节 (180 例中的 142 例；78.9%) 和 TR5 结节 (65 例中的 42 例) 显示良性 (Bethesda 类别 II) 细胞学。TR5 中有 14 例 (42.4%) 出现恶性 (Bethesda 类别 VI) 细胞学。
尽管没有 TR2 或 TR3 恶性 (Bethesda 类别 VI) 诊断，TR4 和 TR5 类别中也只有少数恶性肿瘤，但目前的结果再次表明，ACR TI-RADS 评分系统显示出良性或恶性细胞学诊断之间至少存在一定相关性，这可以从更高的 ACR TI-RADS 类别中出现更多的恶性病例中看出。
