The Role of the Ultrasound Sign "Calcifications" in the Differential Diagnosis of Thyroid Oncopathology Within the Ti-Rads System

Over the past decades, there has been a steady increase in patients with nodular thyroid neoplasms. Multiparametric ultrasound examination plays a leading role at the stage of preoperative thyroid oncopathology diagnosis. The most difficult task is to choose the tactics in cases of detecting calcifications of focal thyroid formations during ultrasound examination. The aim of the study was to determine the value of the ultrasound sign "calcifications" in the differential diagnosis of thyroid oncopathology within the TI-RADS system. Materials and methods. A retrospective analysis of the medical histories of 167 patients was performed, which were divided into two groups: group 1 – 60 patients with adenomas, group 2 – 60 patients with thyroid cancer. All patients underwent standard ultrasound examination of organs in the gray scale mode (B-mode) and color Doppler imaging mode. The TI-RADS system was used as a system for describing and processing thyroid ultrasound data. Correlation analysis was used to assess the diagnostic volatility of ultrasound signs of the TI-RADS system in detecting focal thyroid pathology. The accuracy of diagnostic tests was assessed using ROC-analysis (AUC). Research results. According to the retrospective analysis, 3 thyroid nodes (2.5%) were classified as TI-RADS2, 19 nodes (15.8%) were classified as TI-RADS3, 78 nodes (65.0%) were classified as TI–RADS4, and 20 nodes (16.7%) were classified as TI-RADS5. A correlation analysis of assessment of the diagnostic volatility of TI-RADS system ultrasound signs in detecting focal thyroid pathology showed the following. According to the scatter of Kendall's coefficient correlations, "macrocalcifications" were determined with a bias for the benign thyroid node (p = 0.039537). When evaluating "microcalcifications" sign (p-value = 0.020209), it was found that in terms of its significance in predicting oncological changes, it was second only to the shape change parameter ("height > width"). Based on the ROC analysis (AUC), it was found that the sign "calcification" ("microcalcifications" + "macrocalcifications") can be considered to be a test of good quality (AUC = 0.783±0.0387, 95% CI = 0.711–0.894). Conclusions. The presence of calcifications both in benign nodules and in thyroid tumors of varying malignancy degrees forces to use a more balanced approach to interpreting this sign of improvement in the differential diagnosis of focal thyroid formations.