IS TIRADS A PRACTICAL AND ACCURATE SYSTEM FOR USE IN DAILY CLINICAL PRACTICE? Presented by Dr Roshan Valentine PG Resident St Johns Medical College Bangalore AUTHORS: Anuradha Chandramohan, Abhishek Khurana, B T Pushpa, Marie Therese Manipadam1, Dukhabandhu Naik2, Nihal Thomas2, Deepak Abraham3, Mazhuvanchary Jacob Paul3, CMC Vellore
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IS TIRADS A PRACTICAL AND ACCURATE
SYSTEM FOR USE IN DAILY CLINICAL PRACTICE?
Presented by Dr Roshan Valentine
PG Resident
St Johns Medical College Bangalore
AUTHORS:Anuradha Chandramohan, Abhishek Khurana, B T Pushpa, Marie Therese Manipadam1, DukhabandhuNaik2,Nihal Thomas2, Deepak Abraham3, MazhuvancharyJacob Paul3, CMC Vellore
INTRODUCTION
• 12% of adult Asian population have a palpable nodule
• 80% among children in iodine-deficient parts of India.
• Incidence of thyroid cancer is low.
• Ultrasound is a widely accepted imaging modality for the initial assessment
• Thyroid Imaging Reporting and Data System (TIRADS) described by Kwak et al.[15] is a relatively simple system which can be easily adopted
OBJECTIVE
To assess
• Positive predictive value
• Inter-observer variability of TIRADS
MATERIALS AND METHODS
STUDY POPULATION• IERB Review
• Dept of radiology at CMC vellore
• Jan 2012 – nov 2012
• Estimated sample size for assessing inter-reader reliability – 250
• 346 nodules of 307 pts
INCLUSION CRITERIA• Solitary nodule and nodules in MNG > 1cm
• FNAC – benign/malignant lesion
• Undergone Surgery -FNAC yielded suspicious for malignancy, indeterminate or inadequate sampling
MATERIALS AND METHODS
THYROID ULTRASOUND• ACUSON S2000 AND ACUSON ANTARES Siemens
• 7-11Mhz probe
• 2 radiologists with 8 years experience
• Reviewed by a 3rd radiologist (3 yrs experience)
• Features assessed for :
1)Composition: solid cystic mixed
2)Echogenicity
3)margins: well defined +/- halo sigin , microlobulated , ill-defined , irregular
4)Calcification :micro/macro
5) Shape : round/t>w or oval
MATERIALS AND METHODS
THYROID ULTRASOUND
Features suggesting malignancy :• Hypoechoic or markedly hypoechoic