FRI522 Impact Of TIRADS Score On Thyroid Nodule Biopsy

Abstract Disclosure: U.B. Adeniran: None. A. Olabumuyi: None. O. Adeniran: None. G. Bahtiyar: None. G. Rodriguez: None. Introduction: Thyroid nodules are prevalent, however many thyroid nodules biopsied are benign. In 2017, the Thyroid Imaging Reporting and Data systems Committee of the American college of Radiology (TI-RADS) presented the use of TI-RADS score to risk stratify nodules to TR1 to TR5 with recommendations on biopsy vs follow up. The aim of our study was to ascertain any changes in thyroid biopsy rate before and after the use of ACR TI-RADS in thyroid ultrasound scans in a community hospital in Brooklyn, NY. Methods: We conducted a retrospective single center observational cohort study on patients referred for thyroid nodule assessment between March 2019 - March 2020 & March 2021 - March 2022. Inclusion criteria- all patients with thyroid ultrasound scans without TI-RADS scoring from March 2019- March 2020, all patients with TI-RADS scoring from March 2021-March 2022. Duplicate referrals, patients lost to follow up, incomplete records were excluded. Primary endpoint was to ascertain any differences in thyroid biopsy recommendation rate before and after the use of TI-RADS score in ultrasounds. Chi square test was used to determine the association between TI-RADS use in ultrasound scans and thyroid biopsy recommendation rate. Thyroid nodules were categorized based on the Bethesda System for Reporting Thyroid Cytopathology (BSRTC). Results: A total of 91 patients met the inclusion/exclusion criteria, 13 men and 78 women (M:F- 1:6). Thyroid nodules of 53 patients on ultrasound were reported using TI-RADS score and 38 patients without using the TI-RADS score. TI-RADS group and non TI-RADS group were similar in age, gender, race, and ethnicity. The use of the TI-RADS reporting system was associated with a statistically significant reduction in recommendation for biopsy. Only 26.4% of the patients who had TI-RADS were recommended for biopsy compared to 47.4% of the patients who did not have TI-RADS (P-Value 0.039).A total of 32 patients were recommended for biopsy, however biopsy was done in 26 patients. Majority of the nodules biopsied were benign (BSRTC II), 10 of 14 patients (71.5%) were benign (BSRTC II) in Non TI-RADS group, and 8 of 12 (66.7%) were benign (BSRTC II) in TI-RADS group. Conclusion: TI-RADS score significantly reduced the biopsy recommendations. Its implementation thus results in saving the Healthcare commission a significant cost of unnecessary biopsy in the region of $1,999 per biopsy. With the implementation of TIRADS, the proportion of malignant biopsies was expected to rise. However, there was no significant difference in this group. This may be because the total number of biopsies analyzed was small. It could also be that some of the nodules the TIRADS score did not recommend for biopsy may have been malignant. Further studying of a larger cohort is thus warranted. Presentation: Friday, June 16, 2023