Comparison of Sonographic-Based TI-RADS Classification and Cytological-Based Bethesda Scoring: 6-Month Experience in Somalia

Abstract

The aim of this study is to investigate the agreement between ‎the thyroid image reporting and data systems (TI-RADS) ‎classification and the Bethesda scoring in adults with thyroid ‎nodules and to evaluate the effectiveness of our clinic in the ‎management of thyroid nodules. In this prospective study, in ‎which the analyzes of the patients who applied to the ‎Interventional Radiology Department of our hospital for fine ‎needle aspiration biopsy due to thyroid nodule were analyzed, ‎‎59 patients were included between January 1, 2020 and June ‎‎1, 2020. Sonographic features (composition, echogenicity, ‎shape, margin, and echogenic foci) of all nodules were recorded ‎for TI-RADS scoring before biopsy and TI-RADS scoring was ‎performed by the radiologist. It was then the results compared ‎with the Bethesda scoring, which is the cytological ‎classification. A total of 59 patients (n=43; 72.9% female and, ‎n=16; 27.1% male) were analyzed. Of the biopsied nodules, 31 ‎‎(52.5%) were localized in the right lobe and 28 (47.5%) in the ‎left lobe. The mean longest diameter of the nodules was ‎‎35.9±13.9 mm (range, 13-70 mm). The TI-RADS category was ‎also significantly higher in those with larger nodule diameters ‎‎(p=0.026). There was moderate agreement between both ‎scorings (kappa value=0.406 and p<0.001). There were 7 ‎‎(11.9%) patients with TI-RADS ≥ 4 and 10 (16.9%) patients ‎classified as Bethesda ≥ 4. Thyroid nodules reported as highly ‎suspected of malignancy (TIRADS ≥ 4) had good agreement ‎with Bethesda scoring (Kappa value= 0.658 and p<0.001). ‎According to the findings of our study, there is a moderate ‎agreement between TI-RADS scoring and Bethesda. However, ‎the rate of compliance was increasing in nodules classified as ‎malignant nodules (TI-RADS ≥4).‎