Agreement Between Ti-RADS Classification and Bethesda Cytopathological Findings from Thyroid Nodules in Young Adults. Issue 11 (30th December 2020)

• Record Type: Journal Article
• Authors: Zloczower, Elchanan; Atas, Ofir; London, Daniel; Elharar, Limor; Jacobe-Levy, Maayan; Marom, Tal
• Is Part Of: Military medicine. Volume 185:Issue 11/12(2020)
• Page Start: 2020
• Page End: 2025
• Publication Date: 2020-12-30
• Subjects: Surgery, Military -- Societies, etc; Medicine, Military -- Societies, etc; Medicine, Military -- Periodicals; Surgery, Military -- Periodicals; Medicine, Military; Surgery, Military; Military Medicine -- Periodicals; Periodicals; Electronic journals; 616.98023
• DOI: 10.1093/milmed/usaa174
• Languages: English
• ISSNs: 0026-4075

Abstract

Abstract: Introduction: Thyroid nodules are common in young adults. We sought to compare the sonographic characteristics (thyroid imaging reporting and data system [Ti-RADS] classification) with the reported cytological results (Bethesda categories) from thyroid nodules in young recruits and examine the efficiency of our unique multidisciplinary clinic. Materials and Methods: In this retrospective cohort, we identified young recruits (18–25 years) who underwent needle biopsies for asymptomatic thyroid nodule(s), with cytology reports of Bethesda categories II-V, performed in our "Rapid Diagnostic Service" at a large Israeli Defense Forces Medical Corps healthcare facility, between 2013 and 2018. We studied the concordance rates between their Ti-RADS and Bethesda grades, and the preoperative Bethesda grades accuracy versus final pathology results, and the time period needed for their thyroid nodules workup. Results: A total of 81 patients were included who contributed 91 nodules. A fair agreement was found between the Ti-RADS classifications and the Bethesda grades (Cohen's κ = 0.238) that was more noticeable in males than in females. The agreement rate was 87.5% in males (21 of 24), but only 77.6% in females (59 of 67) [ P = .029]. Of the 5 operated benign cases, all had low Ti-RADS, and 2 had low Bethesda. Of the 8 operated malignant cases, 6 had high Ti-RADS, and 5 had high Bethesda. On average, 37.64 days elapsed between the first visit to the ultrasound study, and 24.2 days elapsed until biopsy was performed. Conclusions: Despite an overall fair agreement between the sonographic features and cytological findings in young adults, we recommend a more aggressive approach and repeated biopsies despite reported benign pathology, because of a high false-negative rate.