Role of TIRADS and Bethesda Scoring Systems in Management of Thyroid Nodules

doi:10.21608/ejhm.2025.449119

Role of TIRADS and Bethesda Scoring Systems in Management of Thyroid Nodules

Document Type : Original Article

10.21608/ejhm.2025.449119

Abstract

Background: Fine-needle aspiration (FNA) is the first-line diagnostic procedure, with the Bethesda System used to classify cytology findings into six categories based on malignancy risk. Despite some diagnostic variability, this system enhances diagnostic accuracy and minimizes unnecessary surgeries. Objective: This study aimed to measure the correlation between the thyroid imaging reporting and data systems (TIRADS) and Bethesda scoring systems and the final histopathology, whether benign or malignant, in thyroid nodules (TNs). Patients and Methods: This cross-sectional observational study was conducted on 30 patients with single or multiple thyroid nodules measuring more than 1cm. All patients underwent FNA cytology from suspicious nodules. Patients with thyroid nodules that are smaller than 1cm, history of thyroid surgery and history of radiotherapy were excluded from the study.
Results: TIRAD can significantly predicted histopathology (P = 0.018, AUC = 0.683) at cut-off ≤ 3 with 90.00 % sensitivity, 45.00 % specificity, 71.1 % PPV and 75.0% NPV. Bethesda system significantly predicted histopathology (P = 0.032, AUC = 0.659) at cut-off ≤ 2 with 73.33 % sensitivity, 55.00% specificity, 71.0% PPV and 57.9% NPV.
Conclusions: Both TIRAD and the Bethesda system are significant predictors of the histopathology of thyroid nodules, with superiority of TIRAD in sensitivity (90%) compared to the Bethesda system (73.33 %).

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