TI-RADS Scoring in Surgical Decision-Making for Bethesda III Thyroid Nodules: A Retrospective Analysis
Acta Cytologica, ss.1-8, 2026 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Basım Tarihi: 2026
- Doi Numarası: 10.1159/000552301
- Dergi Adı: Acta Cytologica
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, CINAHL, EMBASE, MEDLINE
- Sayfa Sayıları: ss.1-8
- Anahtar Kelimeler: Bethesda category III, Thyroid nodules, TI-RADS, Surgical decision-making, Ultrasonography, Malignancy risk
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Introduction: The aim of this study was to evaluate the contribution of ACR TI-RADS scoring system to surgical decision-making in Bethesda category III thyroid nodules and investigate its role in malignancy risk stratification. Methods: This retrospective cross-sectional study evaluated 285 patients with 294 thyroid nodules classified twice as Bethesda category III who underwent thyroidectomy at a tertiary care center between 2018 and 2023. ACR TI-RADS scores were calculated based on standardized ultrasonographic features. Primary outcome was malignancy rate according to histopathological examination. Statistical analyses included chi-square test, Mann-Whitney U test, and logistic regression. Results: Among 294 nodules, malignancy was detected in 39.8% (n = 117). TI-RADS categories showed progressive malignancy rates: TI-RADS 2 (26.9%), TI-RADS 3 (32.0%), TI-RADS 4 (41.5%), and TI-RADS 5 (82.8%). Logistic regression identified age (OR = 0.95), hypoechogenicity (OR = 2.92), and microcalcification (OR = 3.65) as independent predictors. The scoring system demonstrated 57.0% sensitivity, 90.0% specificity, 82.8% positive predictive value, and 73.1% negative predictive value for TI-RADS 5 versus TI-RADS 2. Conclusion: ACR TI-RADS scoring system provides valuable contribution to surgical decision-making in Bethesda category III thyroid nodules through its high specificity and positive predictive value, particularly for TI-RADS 5 category.