Diagnostic Accuracy of Ultrasonography Scan to Differentiate Benign Versus Malignant Nodules of the Thyroid Gland Using Histopathology as Gold Standard
Naima Mujahid, Ayesha Mahmud, Areesha Zakir
DOI: http://doi.org/10.63139/aqamc.v2i1.0016
Keywords: Doppler Ultrasonography, TIRADS, Thyroid Nodules, Histopathology, Diagnostic Accuracy, Sensitivity, Specificity
ABSTRACT
Introduction: Thyroid nodules are increasingly detected due to the widespread use of ultrasound imaging. While most nodules are benign, a small proportion may be malignant. Accurate and non-invasive diagnosis is essential to avoid unnecessary biopsies and reduce morbidity. The American College of Radiology (ACR) TIRADS classification system has enhanced the role of Doppler ultrasonography in stratifying the risk of malignancy in thyroid lesions.
Objective: To determine the diagnostic accuracy of Doppler ultrasonography in differentiating benign from malignant thyroid nodules, using histopathology as the gold standard.
Methods: This comparative cross-sectional study was conducted at the Radiology and Pathology Departments of Shahida Islam Medical Complex, Lodhran, from June 2023 to July 2024. A total of 60 patients aged 18–60 years with solitary thyroid nodules were enrolled. All participants underwent Doppler ultrasonography with TIRADS classification, followed by fine needle aspiration cytology and histopathological confirmation. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and overall diagnostic accuracy were calculated using a 2×2 contingency table.
Results: The mean age of patients was 34 years; 67% were female. Ultrasonography showed a sensitivity of 83.33%, specificity of 86.11%, PPV of 80%, and NPV of 88.97%. The overall diagnostic accuracy of ultrasonography in distinguishing benign from malignant nodules was 85%. Conclusion: Doppler ultrasonography, when combined with TIRADS scoring, demonstrates high diagnostic accuracy for thyroid nodules. It serves as a valuable, non-invasive tool for risk stratification and guiding the need for histopathological confirmation
Keywords: Doppler Ultrasonography, TIRADS, Thyroid Nodules, Histopathology, Diagnostic Accuracy, Sensitivity, Specificity