AB125. SOH24AB_215. Assessing the use of thyroid imaging reporting and data systems and Thy scoring in thyroid nodules: a retrospective review

Background: Thyroid nodules are common in the general population and frequently found incidentally. Despite improved methods to stratify thyroid nodules into low, medium and high-risk categories on ultrasonographic imaging, it is postulated that up to 95% of all nodules are ultimately benign. Ultrasound is a vital diagnostic tool in assessing thyroid nodules. Multiple characteristics of the nodule on ultrasound can be used to determine the need for further investigation. Our study aimed to ascertain the level, if any, of discordance that may be evident between the thyroid imaging reporting and data systems (TIRADs) score and Thy score attributed to a nodule.

Methods: We performed a retrospective chart review of patients who underwent ultrasound and fine needle aspiration (FNA) of an indeterminate thyroid nodule between January 2022 and July 2023 in a tertiary referral centre. Information including TIRADS, Thy score, nodule characteristics and patient demographics were collated. Sensitivity and specificity were calculated on an individual TIRADs scoring basis.

Results: A total of 262 patients were included in our study, with a total of 307 FNAs performed. In keeping with current literature, most patients included were female (79%). And, 97% of ultrasounds performed were for nodules categorised as TIRADs 3, 4 and 5. On review of all TIRADs 3/4/5 nodules, 75.2% of these nodules were assigned a Thy2 grading, requiring no further intervention. Last, 5.5% of nodules were found to represent papillary thyroid carcinoma.

Conclusions: Although a cheap and reproducible method of thyroid nodule classification, characteristics of thyroid nodules on routine ultrasound may tend toward over-investigation and invasive procedures in many patients.

Keywords: Fine needle aspiration (FNA); nodule; thyroid imaging reporting and data systems (TIRADs); thyroid; ultrasound