Does ACR TI-RADS increase efficacy of thyroid ultrasounds?

Abstract

Background: The American College of Radiology Thyroid Imaging Results and Data System (ACR TI-RADS) is a risk stratification system (RSS) to assess ultrasounds of thyroid nodules. This study aims to evaluate if the implementation of ACR TI-RADS reduces fine needle aspiration cytology (FNAC) of benign nodules.

Material & methods: All patients diagnosed with a thyroid nodule, and who received an ultrasound between January 2018 and February 2020 were included. Period I included patients undergoing ultrasound before implementation of ACR TI-RADS and period II after implementation. The impact of ACR TI-RADS on the number of FNACs with the accompanying cytological results and guideline concordance were analyzed.

Results: In this study, 787 patients and 889 ultrasounds were included. Of these ultrasounds, 403 were performed in period I and 486 in period II. The proportion of ultrasounds leading to FNAC decreased significantly since implementation (51.6 % vs. 43.6 %, p = 0.018) while the proportion of benign cytology results decreased significantly as well (84.4 % vs. 73.6 %, p = 0.020). Furthermore, since ACR TI-RADS implementation, physicians followed the accompanying guidelines on follow-up in 70.4 % of the cases.

Conclusion: A decrease of FNAC of benign thyroid nodules was observed since implementation of ACR TI-RADS and this RSS was easily implemented in our clinic.

Keywords: ACR TI-RADS; Cost-effective; Efficacy; Nodules; Thyroid.