Accuracy of the Combination of TI-RADS and BETHESDA Regarding Histopathology of Thyroid Malignancy

Background and aim of the work: Thyroid carcinoma is a common type of cancer, making up 2.1% of all new cancers. Ultrasonography (USG) is used to check thyroid nodules. TI-RADS is a system that classifies thyroid nodules based on USG. High-risk nodules undergo fine-needle aspiration biopsy (FNAB), and the results are reported using the BETHESDA classification. This study aimed to determine how accurate TI-RADS and BETHESDA are together for diagnosing thyroid cancer. Research design and methods: This observational study examined data from thyroid cancer patients. We assessed characteristic data comprising age, gender, TI-RADS, BETHESDA, and thyroid malignancy histopathology. An independent t-test and Fisher exact test assessed the relationships between TI-RADS, BETHESDA, and thyroid malignancy histopathology. Diagnostic tests were based on ROC curve analysis of FNAB (BETHESDA), USG (TI-RADS), and a combination of both in establishing a diagnosis of malignancy based on the results of histopathological examination. Results: This study included 47 patients. FNAB (BETHESDA) was more accurate at 80.85% compared to USG (TI-RADS) and their combination. Similarly, FNAB (BETHESDA) had a higher sensitivity at 80.48% compared to USG (TI-RADS) and their combination. However, when FNAB (BETHESDA) and USG (TI-RADS) were combined, they had the highest specificity values, reaching 100.0%, compared to each examination alone. Conclusions: The study found that while FNAB (BETHESDA) is accurate and sensitive, combining it with USG (TI-RADS) improves specificity, making it a valuable approach for clinical decision-making. This integration could lead to better diagnostic accuracy and patient outcomes by providing a more comprehensive assessment of thyroid nodules.