THI-RADS. US differentiation of thyroid lesions.

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THI-RADS. US differentiation of thyroid lesions. Poster No.: C-0864 Congress: ECR 2015 Type: Scientific Exhibit Authors: A. N. Sencha, Y. Patrunov, M. S. Mogutov, E. Penyaeva, A. 1 1 1 2 1 1 1 2 Gruzdev, E. Sencha ; Yaroslavl/RU, Moscow/RU Keywords: Tissue characterisation, Image verification, Cancer, Diagnostic procedure, Ultrasound, Thyroid / Parathyroids DOI: 10.1594/ecr2015/C-0864 Any information contained in this pdf file is automatically generated from digital material submitted to EPOS by third parties in the form of scientific presentations. References to any names, marks, products, or services of third parties or hypertext links to thirdparty sites or information are provided solely as a convenience to you and do not in any way constitute or imply ECR's endorsement, sponsorship or recommendation of the third party, information, product or service. ECR is not responsible for the content of these pages and does not make any representations regarding the content or accuracy of material in this file. As per copyright regulations, any unauthorised use of the material or parts thereof as well as commercial reproduction or multiple distribution by any traditional or electronically based reproduction/publication method ist strictly prohibited. You agree to defend, indemnify, and hold ECR harmless from and against any and all claims, damages, costs, and expenses, including attorneys' fees, arising from or related to your use of these pages. Please note: Links to movies, ppt slideshows and any other multimedia files are not available in the pdf version of presentations. www.myesr.org Page 1 of 13

Aims and objectives We aimed to analyze ultrasound (US) features of thyroid lesions to assess the criteria for stratification of the risk of malignancy. Methods and materials Thyroid US was performed in 13532 patients. Fine needle aspiration biopsy (FNAB) with cytology was done in 1081 thyroid lesions. 799 patients underwent thyroid surgery and had pathologic verification. The age ranged from 18 to 85 years. Results The sonographic features of the thyroid gland with standard US protocol were compared with cytologicy and pathology. US detected normal thyroid (21%), diffuse enlargement (11%), colloid nodules, including cysts (22%), autoimmune thyroid (AITD), Graves' disease, subacute thyroiditis, and other diffuse conditions (22%), combined diffuse and focal changes (16%), nodules suspicious for carcinoma (exhibiting less than 50-70% of typical malignant features) (7%), nodules highly suspicious for cancer (70-90% of typical malignant features) (1%). Detected abnormalities were grouped in accordance with the risk of malignancy: benign, doubtful, or malignant nodules. Comparison of US data, FNAB with citology, and morphological examination allowed to define the risk of malignancy with scoring from 1 to 5 (THI-RADS). The first THI-RADS group included normal and diffusely enlarged thyroid gland (probability of malignancy 0%), THI-RADS 2 (Fig. 1-2) - type 1 colloid nodules and type 1 focal changes in AITD, Graves' disease, SAT (probability of malignancy 0%), THI-RADS 3 (Fig. 3-4) - type 2 colloid nodules (probability of malignancy 10%) and type 2 focal changes in AITD (Fig. 5), Graves' disease, SAT (probability of malignancy 16%), THI-RADS 4 (a and b) - nodules suspicious for cancer (probability of malignancy 80-90%) (Fig. 6-8), THI-RADS 5 (Fig. 9-10) - verified tumor (100% malignant). Groups 3-4 were subject to FNAB. Images for this section: Page 2 of 13

Fig. 1: THI-RARS 2. Colloid nodule. Page 3 of 13

Fig. 2: THI-RADS 2. Colloid nodule. Page 4 of 13

Fig. 3: THI-RADS 3. Page 5 of 13

Fig. 4: THI-RADS 3. Page 6 of 13

Fig. 5: THI-RADS 3. Nodule with AITD. Page 7 of 13

Fig. 6: THI-RADS 4. Page 8 of 13

Fig. 7: THI-RADS 4. Page 9 of 13

Fig. 8: THI-RADS 4. Page 10 of 13

Fig. 9: THI-RADS 5. Hypervascular lesion. Page 11 of 13

Fig. 10: THI-RADS 5. Hypervascular lesion. Page 12 of 13

Conclusion THI-RADS permits oncologic risk stratification and standartization of US reports. Personal information Alexander N. Sencha. Head of the Center for Radiology, Yaroslavl Railway Clinic, Yaroslavl, Russia; senchavyatka@mail.ru References 1. Horvath E, Majlis S, Rossi R, et al. An ultrasonogram reporting system for thyroid nodules stratifying cancer risk for clinical management. J Clin Endocrinol Metab 2009; 94(5): 1748-51 2. Kharchenko V.P., Kotlyarov P.M., Mogutov M.S. et al. Ultrasound Diagnostics of Thyroid Diseases. Springer-Verlag, 2010. 3. American Thyroid Association (ATA) Guidelines Taskforce on Thyroid Nodules and Differentiated Thyroid Cancer, Cooper DS, Doherty GM, Haugen BR et al. Revised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid 2009; 19(11): 1167-214. 4. Frates MC, Benson CB, Charboneau JW et al. Management of thyroid nodules detected at US: Society of Radiologists in Ultrasound consensus conference statement. Radiology 2005; 237(3): 794-800. 5. Park SH, Kim SJ, Kim EK, et al. Interobserver agreement in assessing the sonographic and elastographic features of malignant thyroid nodules. AJR Am J Roentgenol 2009; 193(5): W416-23. Page 13 of 13

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