Correlative Study of ACR-TIRADS (2017) with Histopathological Evaluation of Thyroid Nodules in a Peripheral Medical College in West Bengal

Background: Thyroid swelling is a common clinical finding with a quiet high prevalence among Indian population. Risk stratification of these thyroid swellings into benign and malignant hence become a crucial part in the management of these cases. Here comes the role of ultrasonography, with its added benefits of portability, cost effectiveness, lack of ionizing radiations and non-invasiveness. To standardize ultrasound findings Thyroid Imaging Recording and Data System (TIRADS) classification are used. Methods: History and physical examination were done in all cases of thyroid nodule. Serum TSH, T3, T4, pre and post operative calcium on post operative day 3 were done in all cases. Ultrasonography and fine needle aspiration Cytology (FNAC)/ultrasonography guided if nodule size less than 1cm were done in all cases. All patients underwent surgical intervention, and specimens were sent for Histopathology examinations. Result: Common age groups were 25 to 44 years, and more than 80% cases were female. 65% cases were less than TIRADS 4 and 35% cases were more than TIRADS 4. Patients with TIRADS score of 4 and more were having higher chance of being suspected with malignancy on histopathology examination than the patients with score of less than 4. On the basis of sonographic findings, half of the subjects among solid components were found to be having malignancy, whereas, more than half of the subjects with micro-calcifications were having malignancy and all the subjects with irregular margins were diagnosed with malignancy on HPE. Conclusions: Thyroid ultrasound plays a key role in diagnosis, and it allows for the morphological characterization of Thyroid nodules, thereby facilitating adequate selection of those nodules amenable to FNAB cytological diagnosis. There is paucity of data regarding TIRADS score and its relationship with thyroid pathology in this part of the world. This study was an honest attempt to fill this gap, which would be helpful in managing the thyroid disorder more efficiently and will be convenient for risk stratification.