Burg, S.J.C. van der (Stijn) (2021) Implementation of ACR TI-RADS results in less unnecessary fine needle aspirations of thyroid nodules. thesis, Medicine.
Full text available on request.Abstract
Background The American College of Radiology Thyroid Imaging Results and Data System (ACR TI-RADS) is a risk stratification system to assess ultrasounds of thyroid nodules. One of the goals of ACR TI-RADS is to reduce unnecessary diagnostic measures and overdiagnosis. In Dutch practice it is not widely used. Assessment of implementation of ACR TI-RADS in a large teaching hospital was done to evaluate the efficacy. Material & Methods All patients who received an ultrasound to examine thyroid nodules between January 2018 and February 2020 were selected. Patients were assigned in two groups: before implementation of ACR TI-RADS (group 1) and after (group 2). The impact of ACR TI-RADS on the number of fine needle aspirations (FNA) and diagnostic surgeries with the accompanying cytologic and histologic results was analysed. Furthermore, it was evaluated whether ACR TI-RADS was implemented well. Results In group 1, 380 patients were included and 407 in group 2. In group 1 and 2, the number of FNA’s was 194 (51.1%) and 201 (49.4%) (p=0.640), respectively. The FNA’s in group 1 resulted in Bethesda I-II in 85.1% (n=165) and in Bethesda III-VI in 14.9% (n=29). In group two, the percentages are 74.4 (n=150) and 25.6 (n=51) (p=0.010), respectively. The Bethesda scores of III-VI resulted in 20 patients being operated in group 1 and 40 in group 2 (p=0.207), which led to 8 (42.1%) and 20 (50.0%) malignancies to be found, respectively (p=0.570). Since implementation, 345 nodules (84.8%) were scored according to ACR TI-RADS and physicians followed the accompanying guidelines on follow-up in 80.8% (n=286) of the cases. Conclusion The implementation of ACR TI-RADS results in significantly less FNA’s resulting in Bethesda I-II. Therefore, it can be concluded that ACR TI-RADS helps reducing unnecessary diagnostic measures. Furthermore, the risk stratification system seems save and easy to implement.
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | Francken, dr. A.B. |
| Faculty: | Medical Sciences |
| Date Deposited: | 07 Jan 2022 08:25 |
| Last Modified: | 07 Jan 2022 08:25 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/2976 |
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