APPLICATION OF EU-TIRADS 2017 CLASSIFICATION IN MALIGNANCY RISK STRATIFICATION SYSTEM OF THYROID NODULES AT CAN THO ONCOLOGY HOSPITAL FROM 2021 TO 2023

Huynh Nhu Vo1,, Phuoc Bao Quan Nguyen1, Doan Ngoc Tuan Pham1, Thi Anh Thu Pham1, Hoang An Nguyen1
1 Can Tho University of Medicine and Pharmacy

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Abstract

Background: Thyroid nodules are highly prevalent, with an occurrence of up to 68% in random ultrasound examinations among adults, primarily of benign nature. Early detection of nodules and risk stratification systems (RSS) play a crucial role in guiding their monitoring and treatment. Ultrasound and fine-needle aspiration biopsy (FNAB) are the primary modalities employed in the management of thyroid nodules. Various Thyroid Imaging Reporting and Data Systems (TIRADS) have been developed globally, utilizing ultrasound features such as composition, margin, shape, echogenicity, and echogenic foci. The EU-TIRADS classification system, focusing on key malignant features while ensuring accessibility, has been studied in many countries, including in Vietnam. Objectives: To describe the ultrasound characteristics of thyroid nodules and evaluate their classification using the EU-TIRADS 2017 system, further assessing its correlation with histopathological results. Materials and methods: The study included patients who had ultrasound findings described according to the TIRADS system, underwent surgery, and had histopathological results available. The research employed a cross-sectional descriptive methodology. Results: The analysis of 210 thyroid nodules in 135 patients revealed the following key findings: There was a maleto-female ratio of 1:7, and the average age of the patients was 44 years. The nodules exhibited an average size of 21 mm and commonly displayed features such as a mixed solid and cystic composition, hypoechoic appearance, smooth margins, oval shape, and an absence of echogenic foci. When comparing the EU-TIRADS classification with histopathological results, the distribution of nodules across the EU-TIRADS 2, 3, 4, and 5 categories was 3%, 35%, 29% and 33%, respectively. The corresponding malignancy rates were 0%, 4.3%, 39.7%, and 56%. In terms of diagnostic performance, the EU-TIRADS system demonstrated a high sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of 96%, 81%, 86%, 94%, and 89%, respectively, in effectively distinguishing between benign and malignant nodules. Conclusions: The EU-TIRADS 2017 system proved to be highly valuable in evaluating thyroid nodules, particularly in the TIRADS 5 classification.

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References

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