L.A. TIMOFEEVA^1,2, A.N. SENCHA³

¹Chuvash State University named after I.N. Ulyanov, 15 Moskovskiy prospekt, Cheboksary, Russian Federation, 428015

²Republican Clinical Oncology Center of the Public Health Ministry of the Chuvash Republic 31 Gladkov Str., Cheboksary, Russian Federation, 428015

³National Medical Research Center of Obstetrics, Gynecology, and Perinatology named after Academician V.I. Kulakov, Ministry of Health of Russia, 4 Acad. Oparina Str., Moscow, Russian Federation, 117997

Contact:

Timofeeva L.A. – Cand. Med. Sc., Associate Professor of the Department of Propedeutics of Internal Diseases with a course of radiodiagnostics, tel. +7-905-130-52-2, e-mail: adabai@mail.ru

Sencha A.N. – D. Med. Sc., Head of the Visual Diagnostics Department, tel. +7-905-130-52-23, e-mail: asencha@yandex.ru

The work is based on the results of ultrasound examination of 2076 patients of active treatment group (N1) and 100 patients of the control group (N2). Active treatment group (N1) patients were distributed to TI-RADS categories by ultrasound protocols results. Our data showed that in active treatment group (N1) 1011 patients were referred to category TI-RADS 2 (48.7%, p < 0.05), 10 patients (14.93%, p < 0.05) were referred to TI-RADS 3, 473 patients (22.78%, p < 0.05) – to TI-RADS 4а, 116 patients (5.59%, p < 0.05) – to TI-RADS 4b, and 166 patients (8.0%, p < 0.05) – to TI-RADS 5. Signs of TI-RADS 3 category were identified in thyroid cancer in 6 cases (2.0%), those of TI-RADS 4a (possibly cancerous node) – in 24 (8.0%) cases, TI-RADS 4b (most likely malignant) – in 106 cases (36.0%), TI-RADS 5 (malignant) – in 160 cases (54.0%).Taking into account the TI-RADS category, indications for fine-needle aspiration biopsy were defined. Sensitivity of multi-parametric ultrasound examination increased to 95%, its specificity – to 90.1% and diagnostic accuracy – to 91%.

Key words: nodular palpable abnormalities, thyroid cancer, multi-parametric ultrasound examination, TI-RADS system, fine-needle aspiration biopsy.

REFERENCES

1. Dedov I.I., Mel’nicheko G.A. Rossiyskie klinicheskie rekomendatsii. Endokrinologiya [Russian clinical guidelines. Endocrinology], 2016. 592 p.
2. Guth S., Theune U., Aberle J., Galach A., Bamberger C.M. Very high prevalence of thyroid nodules detected by high frequency (13 MHz) ultrasound examination. Eur J Clin Invest., 2009, no. 39, rr. 699-706.
3. Statisticheskiy ezhegodnik Chuvashskoy Respubliki [Statistical Yearbook of the Chuvash Republic], 2015.
4. Sencha A.N. Ultrasonic visualization of malignant tumors of the thyroid gland. Ul’trazvukovaya i funktsional’naya diagnostika, 2008, vol. 2, pp. 20–29 (in Russ.).
5. Valdina E.A. Zabolevaniya shchitovidnoy zhelezy. 3-e izd. [Diseases of the thyroid gland. 3rd ed.]. Saint Petersburg: Piter, 2006. 368 p.
6. Sencha A.N. Ul’trazvukovaya diagnostika poverkhnostno raspolozhennykh organov [Ultrasonic diagnostics of superficially located organs], 2015. 512 p.
7. Dean D.S., Gharib H. Epidemiology of thyroid nodules. Best Pract Res Clin Endocrinol Metab., 2008, no. 22, rr. 901-911.
8. Reiners C., Wegscheider K., Schicha H. et al. Prevalence of thyroid disorders in the working pop-ulation of Germany: ultrasonography screening in 96,278 unselected employees. Thyroid, 2004, no.14, rr. 926-932.
9. Timofeeva L.A., Aleshina T.N. Application of the TI-RADS system in differential diagnostics of thyroid cancer in the Chuvash Republic. Kazanskiy meditsinskiy zhurnal, 2017, no. 4, pp. 632-636 (in Russ.).
10. Fernández Sánchez J. TI-RADS classification of thyroid nodules based on a score modified ac-cording to ultrasound criteria for malignancy. Rev. Argent. Radiol., 2014, no. 78 (3), rr. 138–148.
11. 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, no. 94(5), rr. 1748–1751.
12. Tessler F.N., Middleton W.D., Grant E.G., Hoang J.K. ACR Thyroid Imaging, Reporting and Da-ta System (TI-RADS): White Paper of the ACR TI-RADS Committee. Journal of the American College of Radiology, 2017, May, no. 14(5), rr. 587–595.
13. Zabolotskaya N.V., Zabolotskiy V.S. Novye tekhnologii v ul’trazvukovoy mammografii: prakticheskoe rukovodstvo [New Technologies in Ultrasound Mammography: A Practical Guide], 2010. 256 p.