Evaluating the Diagnostic Accuracy of the Thyroid Imaging Reporting and Data System with Fine Needle Aspiration Cytology Result at Jimma University Medical Center, Jimma; South West Ethiopia: Retrospective Study from March 2025- August 2025

Abstract

Background: Ultrasonography is a noninvasive modality for the initial assessment of thyroid nodules. Ultrasound based risk stratification is a widely used method currently helping to guide management in patients with thyroid nodules; which are common and mostly benign. The use of these risk stratification methods has helped to reduce unnecessary FNAC rates, therefore, reducing the burden both on patients and the health care system. Objective: The objective of our study was to determine the effectiveness of ultrasound-based risk stratification by correlating ultrasound findings and pathologic diagnosis at Jimma University Medical Center (JUMC) Method: Hospital based descriptive cross-sectional study was conducted that recruited 85 patients with thyroid nodules. Pearsons’s correlation was used to establish a relationship between TIRADS and cytology findings. The diagnostic accuracy of TI-RADS was assessed using sensitivity, specificity, positive predictive values, and accuracy Results: Of 85 study participants, 74 (87.1%) were females, and the mean age was 48.16 ± 15.03 years. Three quarters of the thyroid nodules 64(75.3%) were solid or almost solid, 72(84.7%) were shaped wider than tall, 77 (90.6%) had smooth margins, 56(65.9%) were hyper echoic or isoechoic, and 42 (49.4%) had no echogenic foci. TI-RADS 3 was the most common at 42(49.4%). The proportions of malignancy for TI-RADS 3, TI-RADS 4 and TI-RADS 5 were 4.8%, 20.0% and 77.8% respectively. The correlation between ACR TI-RADS and the Bethesda system of thyroid classification scores was r = 0.622. The sensitivity, specificity, positive predictive values, and accuracy of ACR TI-RADS were 88.9%, 59.7%, 37.2%, and 65.9%, respectively. Conclusion: We found that ACR TI-RADS classification is an appropriate and noninvasive method for assessing thyroid nodules in routine practice. It can safely reduce the number of unnecessary fine-needle aspiration in a significant proportion of benign thyroid lesions. ACR TI RADS should be standardized as the screening tool in resource-limited areas.