Rajyakodi Keerthana, Balasubramanian Archana, Sundaram Sandhya, Gnanavel Harini
Pathology, Sri Ramachandra Institute of Higher Education and Research, Chennai, IND.
Radiology, Sri Ramachandra Institute of Higher Education and Research, Chennai, IND.
Cureus. 2024 Oct 2;16(10):e70725. doi: 10.7759/cureus.70725. eCollection 2024 Oct.
Objective The primary objective of this study is to comprehensively evaluate nodular thyroid lesions. By analyzing the morphological characteristics of surgically resected specimens and biopsies, the aim is to establish correlations between the patterns, corresponding clinical diagnoses and radiological findings. Furthermore, the study will investigate cases where there is a discrepancy between imaging and pathological assessments, with the goal of understanding the contributing factors to this discordance and improving diagnostic accuracy. Methodology This retrospective observational study utilized convenience sampling to recruit participants. Sample size was determined using GPower software (Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Germany). Statistical analysis was performed using Jamovi 2.3.28 (Jamovi Research, Vienna, Austria). The Chi-square test was employed to assess the association between the Thyroid Imaging Reporting and Data System (TIRADS) score and histopathological diagnosis. Receiver operating characteristic (ROC) analysis was conducted to identify the optimal TIRADS cut-off point for classifying nodules as malignant and to evaluate the diagnostic accuracy of TIRADS. Discordant cases between histopathological and radiological findings were analyzed to investigate potential discrepancies. Result Taking into consideration histopathology report as a gold standard, correlation of TIRADS with histopathology findings, TIRADS showed 73.08% sensitivity and 81.08% specificity, showing the strongest balance between sensitivity and specificity, as demonstrated by the Youden's Index and Metric Score. The area under the curve (AUC) remains constant at 0.805, suggesting a consistent overall discriminative ability of the TIRADS scale. Conclusion A primary advantage of this study is its exclusive focus on surgically resected nodules, which allows for definitive histological confirmation and thereby ensures the most accurate diagnostic assessment.
目的 本研究的主要目的是全面评估甲状腺结节性病变。通过分析手术切除标本和活检的形态学特征，旨在建立这些模式、相应临床诊断与放射学表现之间的相关性。此外，本研究将调查影像学和病理学评估存在差异的病例，目的是了解导致这种不一致的因素并提高诊断准确性。
方法 本回顾性观察性研究采用便利抽样法招募参与者。样本量使用GPower软件（德国杜塞尔多夫海因里希-海涅大学）确定。使用Jamovi 2.3.28（奥地利维也纳Jamovi Research）进行统计分析。采用卡方检验评估甲状腺影像报告和数据系统（TIRADS）评分与组织病理学诊断之间的关联。进行受试者操作特征（ROC）分析，以确定将结节分类为恶性的最佳TIRADS临界值，并评估TIRADS的诊断准确性。对组织病理学和放射学结果不一致的病例进行分析，以调查潜在差异。
结果 以组织病理学报告作为金标准，TIRADS与组织病理学结果的相关性显示，TIRADS的敏感性为73.08%，特异性为81.08%，如尤登指数和度量得分所示，在敏感性和特异性之间达到了最强的平衡。曲线下面积（AUC）保持在0.805不变，表明TIRADS量表具有一致的总体判别能力。
结论 本研究的一个主要优点是其仅关注手术切除的结节，这使得能够进行明确的组织学确认，从而确保最准确的诊断评估。
