Role of American College of Radiology Thyroid Imaging Reporting and Data System 2017 in Predicting Thyroid Nodule Malignancy: Cytological and Histological Insights in the Local Population of Pondicherry

Abstract Background: Thyroid nodules represent a significant clinical challenge, with potential malignant transformation necessitating precise diagnostic strategies. The American College of Radiology Thyroid Imaging Reporting and Data System (ACR-TIRADS) 2017 emerged as a promising tool for risk stratification, prompting this comprehensive investigation into its diagnostic utility and correlation with histopathological findings. Methodology: A prospective cross-sectional study was conducted on 73 patients, involving comprehensive ultrasound examination and Fine Needle Aspiration Cytology (FNAC). Nodules were evaluated using ACR-TIRADS 2017 classification system, with detailed analysis of ultrasound features and histopathological correlations. Results: The study revealed a female predominance (86.3%), with most patients aged 20-40 years. TIRADS classification showed TR4 as the most significant risk category, with 77.8% malignancy correlation. Ultrasound features demonstrated strong predictive value: solid composition (77.8% sensitivity), irregular margins (100% specificity), and specific calcification patterns were key malignancy indicators. Colloid Nodular Goitre (34.2%) was the most prevalent benign condition, with Papillary Carcinoma (16.5%) being the most common malignancy. Conclusion: ACR-TIRADS 2017 demonstrates robust potential as a risk stratification tool for thyroid nodules, providing clinically valuable insights into nodule characteristics and malignancy risk.