High TIRADS may signal cancer despite benign cytology

Patients with higher ultrasound risk classifications had about 5.7 times the adjusted odds of postoperative malignancy in a selected surgical cohort.

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This retrospective, single-center study included 176 surgically treated patients with Bethesda II benign thyroid cytology and postoperative histopathology.
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Postoperative malignancy was identified in 20 patients (11%), while 156 patients (89%) had benign findings.
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Malignancy was found in 32% of patients with TIRADS classifications of 4 or greater, compared with 7% of those with lower classifications.
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TIRADS classifications of 4 or greater were associated with about 5.7 times the adjusted odds of malignancy, and each additional year of age with about 8% lower odds.
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The authors cautioned that the 11% malignancy rate reflects a selected surgical population and should not be generalized to all patients with Bethesda II nodules.

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