72312 - Accuracy of EU-TIRADS in Assessing Thyroid Nodule with Surgeon-performed ultrasound

Abstract Introduction The aim of this study was to evaluate the accuracy of European Thyroid Imaging and Reporting Data System (EU-TIRADS) in an unselected cohort of thyroid nodule patients with surgeon-performed ultrasound. Method This retrospective cohort study included all patients who underwent thyroid ultrasound with EU-TIRADS classification at the Surgery Department at Uppsala University Hospital between 1 July 2019 and 31 December 2020. Medical charts were reviewed, and the nodules were analyzed by obtaining patient characteristics, EU-TIRADS classification and cytological and/or histological result. Patients without a diagnosis of cancer at the end of the observation period or with a benign pathology were considered benign. Result Some 482 patients fulfilled the inclusion criteria. After exclusion, 282 patients remained, with a total of 390 thyroid nodules. Patients were either operated on (n=122, 31.1%) or observed through the regional medical chart system for at least 37 months (median 43 months). The number of nodules in each EU-TIRADS category were as follows: TIRADS 2; 155 (39.7%), TIRADS 3; 153 (39.2%), TIRADS 4; 45 (11.5%) and TIRADS 5; 37 (9.5%). Risk of malignancy in TIRADS 2 was 2.6%, TIRADS 3; 5.2%, TIRADS 4; 13.3% and TIRADS 5; 32.4%. However, in asymptomatic patients, i.e., patients that were not operated on, none of the nodules classified as TIRADS 2 (n=123) had or developed a clinical malignancy during the observation period. Discussion In this study, surgeon-performed ultrasound with the use of EU-TIRADS classification, accurately identified potentially malignant nodules within a clinical context, with no missed cancer cases detected during follow-up.