Diagnostic Performance of Ultrasonography with ACR TI-RADS in Thyroid Mass in Phetchabun Hospital

Abstract

Current clinical practice guidelines recommend thyroid ultrasonography for all patients presenting with thyroid masses to assess malignancy risk and to guide the decision for Fine-Needle Aspiration (FNA). This study aimed to evaluate the diagnostic performance of thyroid ultrasonography reported according to the American College of Radiology Thyroid Imaging Reporting and Data System (ACR TI-RADS) in predicting thyroid malignancy, using cytopathological findings as the reference standard. A retrospective descriptive study was conducted among outpatients with thyroid masses at Phetchabun Hospital between June 1, 2018, and April 30, 2024. A total of 120 patients who underwent thyroid ultrasonography and had definitive cytopathological results from FNA were included. The majority of patients were female (93.3%), with a mean age of 51.8 ± 13.1 years. The diagnostic performance of ACR TI-RADS demonstrated a sensitivity of 100.0%, a specificity of 17.6%, a positive predictive value of 11.9%, a negative predictive value of 100.0%, and an overall accuracy of 25.8%. These findings indicate that thyroid ultrasonography using the ACR TI-RADS classification showed excellent sensitivity and negative predictive value for excluding malignancy in thyroid masses. In conclusion, ACR TI-RADS is an effective screening tool for differentiating malignant from benign thyroid masses and may contribute to reducing unnecessary FNA procedures in clinical practice.