Correlation between EU-TIRADS score and definitive histology of thyroid nodules operated on in Lomé

Abstract

Context and objective. Thyroid nodules are a common diagnostic problem in resource-limited countries. The aim of the present study was to evaluate the diagnostic performance of the European Thyroid Imaging Reporting and Data System (EU-TIRADS) using ultrasound score. Methods. A series of cases of thyroid nodules (isolated or atypical within a multinodular goiter) diagnosed by ultrasound and operated on, between January 2017 and December 2021, in the ENT Department of the Sylvanus Olympio University Hospital in Lomé was retrospectively analyzed. The diagnostic value (sensitivity, specificity, positive predictive value, negative predictive value and accuracy) of thyroid ultrasound was investigated, taking the anatomopathological finding as a reference. Results. A total of 134 medical records were collected. The mean age was 42.28 ± 12.93 years. Females predominated (94 %). The frequency of thyroid cancer was 8.9 %, with papillary carcinoma predominating, accounting for 91.6% of cancers. On ultrasonography, 24 nodules (18%) were classified EU-TIRADS 2, 72 nodules (54%) EU-TIRADS 3, 19 nodules or 14% EU-TIRADS 4 and 19 (14%) EU-TIRADS 5 nodules. Nodule malignancy increased progressively with EU-TIRADS score. The combination of EU-TIRADS scores 2 and 3 considered benign and the grouping of scores 4 and 5 suggestive of malignant gave a sensitivity, specificity, positive and negative predictive values and accuracy of, respectively, 67% (40-93.3%), 75% (67.7-83.0%), 21% (8.0-34.0%), 96% (91.8-99.8%) and 74.6% with p < 0.004. Conclusion. Thyroid nodules are common, but thyroid cancer remains rare. In the present context, the EU-TIRADS score would be a good tool for recognizing benign nodules, as it would rule out thyroid cancer rather than confirm it.

Received: April 12^th, 2024

Accepted: July 28^th, 2024

https://dx.doi.org/10.4314/aamed.v17i4.6