Indian journal of pathology & microbiology · 2025
Evaluation of concordance between the Bethesda System for Reporting Thyroid Cytopathology 2023 (TBSRTC) and ACR-TIRADS at a tertiary care center in Gujarat.
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Biswas Sushrita, Shah Ina, Goswami Hansa, Chaudhuri Avik
Аннотация
BACKGROUND: Recent advancements in diagnostic techniques have resulted in a higher detection rate of thyroid cancers within existing thyroid nodules. The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) 2023 and the American College of Radiology-Thyroid Imaging Reporting and Data System (ACR-TIRADS) are first-line investigations for thyroid nodules, aiding in diagnosis and management decisions.
OBJECTIVES: To evaluate the concordance between TBSRTC 2023 and ACR-TIRADS in reporting thyroid lesions and assess their accuracy in diagnosing malignancies.
MATERIALS AND METHODS: This retrospective, laboratory data-based study included patients presenting with thyroid nodules, who underwent ultrasonography and fine needle aspiration cytology (FNAC), followed by thyroidectomy. Overall concordance between TBSRTC, ACR-TIRADS, and histopathologic diagnosis was evaluated, along with their diagnostic accuracy. Risk of malignancy (ROM) was calculated for both systems using the final HPE diagnosis.
RESULTS: 115 patient records were analyzed. Interobserver agreement between TBSRTC and ACR-TIRADS was moderate (kappa = 0.493 ± 0.093 [±SE]). ROM across extremes of TBSRTC and TIRADS categories were found to be similar. Higher TBSRTC grades correlated with higher ACR-TIRADS grades (Spearman's rank correlation coefficient = 0.594, P = 4.5 × 10 -16 ). The accuracy of FNAC findings and TIRADS to predict malignancy was 84.35% versus 80.87%, with no statistically significant difference ( P = 0.644).
CONCLUSION: Our findings suggest a good concordance between both reporting systems for thyroid nodules, with moderate interrater agreement. Both systems are equally useful for surgical decision-making and avoiding unnecessary surgeries.
OBJECTIVES: To evaluate the concordance between TBSRTC 2023 and ACR-TIRADS in reporting thyroid lesions and assess their accuracy in diagnosing malignancies.
MATERIALS AND METHODS: This retrospective, laboratory data-based study included patients presenting with thyroid nodules, who underwent ultrasonography and fine needle aspiration cytology (FNAC), followed by thyroidectomy. Overall concordance between TBSRTC, ACR-TIRADS, and histopathologic diagnosis was evaluated, along with their diagnostic accuracy. Risk of malignancy (ROM) was calculated for both systems using the final HPE diagnosis.
RESULTS: 115 patient records were analyzed. Interobserver agreement between TBSRTC and ACR-TIRADS was moderate (kappa = 0.493 ± 0.093 [±SE]). ROM across extremes of TBSRTC and TIRADS categories were found to be similar. Higher TBSRTC grades correlated with higher ACR-TIRADS grades (Spearman's rank correlation coefficient = 0.594, P = 4.5 × 10 -16 ). The accuracy of FNAC findings and TIRADS to predict malignancy was 84.35% versus 80.87%, with no statistically significant difference ( P = 0.644).
CONCLUSION: Our findings suggest a good concordance between both reporting systems for thyroid nodules, with moderate interrater agreement. Both systems are equally useful for surgical decision-making and avoiding unnecessary surgeries.