Abstract

Background: Thyroid nodules are a common clinical entity, with an increasing detection rate due to widespread use of ultrasonography (USG). Differentiating benign from malignant nodules is essential for optimal management. The Thyroid Imaging Reporting and Data System (TIRADS) standardizes sonographic evaluation to stratify malignancy risk, aiding clinical decision-making in a noninvasive manner. Objective: To evaluate the diagnostic accuracy of the TIRADS classification system in the risk stratification of thyroid swellings and to compare its performance with fine-needle aspiration cytology (FNAC) and histopathology. Methods: This was a hospital-based cross-sectional study conducted over one year in the Department of Surgery at Sardar Patel Medical College, Bikaner. A total of 115 patients with thyroid swellings scheduled for surgery were assessed. All underwent USG with TIRADS classification, FNAC based on the Bethesda system, and subsequent histopathological examination. Diagnostic accuracy parameters were calculated using histopathology as the gold standard. Results: Out of 115 patients, 36 (31.3%) were found to have malignant nodules on histopathology. TIRADS demonstrated a sensitivity of 88.2%, specificity of 83.7%, and an overall accuracy of 85.6%. FNAC showed a slightly higher specificity (93.2%) but lower sensitivity (82.4%). Malignancy risk increased proportionally with higher TIRADS categories. Conclusion: TIRADS is an effective, non-invasive tool for thyroid nodule risk stratification. When combined with FNAC, it enhances diagnostic precision and guides surgical decisions. Contribution: This study provides regional validation for TIRADS use in northwest Rajasthan, advocating its integration into routine thyroid nodule assessment protocols.

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