Sonographic evaluation of non-palpable thyroid nodule, correlated with FNA

Background: Thyroid nodules are common findings, often incidentally detected through imaging. Accurate differentiation between benign and malignant nodules is essential to guide management. The Thyroid Imaging Reporting and Data System (TIRADS) offers a standardized approach to assess malignancy risk using ultrasound, while fine-needle aspiration cytology (FNAC) provides histopathological confirmation. Objective: This study aimed to evaluate the diagnostic accuracy of TIRADS in identifying malignant thyroid nodules and correlate its findings with FNAC results. Method: This prospective cross-sectional study was conducted from November 2023 to September 2024 at Benha University Hospital and General Mahalla Hospital. A total of 50 patients (6 males and 44 females) aged 18–75 years with incidentally detected thyroid nodules on imaging were included. All nodules underwent sonographic evaluation using TIRADS classification and ultrasound-guided FNAC. Statistical analysis assessed the diagnostic performance of TIRADS, with histopathological FNAC findings as the reference standard. Results: Of the 50 nodules, 62% were benign, while 38% were malignant based on FNAC findings. TIRADS demonstrated an overall diagnostic accuracy of 88%, with a sensitivity of 84.21% and a specificity of 90.32%. Malignant nodules were significantly associated with higher TIRADS categories, particularly TIRADS 5 (p < 0.001). Conclusion: TIRADS provides a reliable, non-invasive tool for assessing the malignancy risk of thyroid nodules. Its high accuracy, sensitivity, and specificity make it a valuable complement to FNAC in the diagnostic evaluation of thyroid nodules, aiding in clinical decision-making.