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<p>Thyroid swellings represent one of the most frequently encountered endocrine disorders, with their incidence rising worldwide. Achieving an accurate preoperative diagnosis is crucial for distinguishing between benign and malignant lesions and preventing unwarranted surgical interventions. The triple assessment approach, which includes clinical evaluation, ultrasonography, and fine needle aspiration cytology (FNAC), is considered a dependable method, with histopathology remaining the definitive gold standard. This observational study was conducted over an 18-month period. 92 patients with thyroid swellings who underwent clinical evaluation, ultrasonography, FNAC, and subsequent surgical excision were included. A correlation was performed between clinical, radiological, and cytological findings and histopathology. The sensitivity, specificity, and diagnostic accuracy of all parameters were calculated. Out of the total 92 cases, 74 were females and 18 males, with a mean age of 42.7 years. Clinical evaluation suggested benign lesions in 91.3% and malignant in 8.7%. Ultrasonography categorised most patients as TIRADS II (40.2%) or III (41.3%). FNAC findings showed 72.8% benign, 9.8% AUS/FLUS, 7.6% follicular neoplasm, 6.5% non-diagnostic, 2.2% malignant, and 1.1% suspicious for malignancy. Histopathology confirmed 75 benign (81.5%) and 17 malignant (18.5%) cases. The diagnostic accuracy of FNAC improved significantly when interpreted in conjunction with clinical and ultrasonographic findingsTriple assessment is a practical, cost-effective, and reliable method for evaluating thyroid lesions. By combining clinical, radiological, and cytological data, it enhances diagnostic accuracy, reduces unnecessary surgeries, and guides optimal patient management.</p>

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Balancing Bethesda and TIRADS: The Indispensable Role of Triple Assessment in Thyroid Nodule Management

  • 期刊论文

  • 发表日期：

    2026年1月19日

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  • Akriti Jindal,
  • Gargi Kapatia,
  • Manjit Kaur,
  • Vikasdeep Gupta,
  • Vaibhav Saini,
  • Ankita Soni

摘要

Thyroid swellings represent one of the most frequently encountered endocrine disorders, with their incidence rising worldwide. Achieving an accurate preoperative diagnosis is crucial for distinguishing between benign and malignant lesions and preventing unwarranted surgical interventions. The triple assessment approach, which includes clinical evaluation, ultrasonography, and fine needle aspiration cytology (FNAC), is considered a dependable method, with histopathology remaining the definitive gold standard. This observational study was conducted over an 18-month period. 92 patients with thyroid swellings who underwent clinical evaluation, ultrasonography, FNAC, and subsequent surgical excision were included. A correlation was performed between clinical, radiological, and cytological findings and histopathology. The sensitivity, specificity, and diagnostic accuracy of all parameters were calculated. Out of the total 92 cases, 74 were females and 18 males, with a mean age of 42.7 years. Clinical evaluation suggested benign lesions in 91.3% and malignant in 8.7%. Ultrasonography categorised most patients as TIRADS II (40.2%) or III (41.3%). FNAC findings showed 72.8% benign, 9.8% AUS/FLUS, 7.6% follicular neoplasm, 6.5% non-diagnostic, 2.2% malignant, and 1.1% suspicious for malignancy. Histopathology confirmed 75 benign (81.5%) and 17 malignant (18.5%) cases. The diagnostic accuracy of FNAC improved significantly when interpreted in conjunction with clinical and ultrasonographic findingsTriple assessment is a practical, cost-effective, and reliable method for evaluating thyroid lesions. By combining clinical, radiological, and cytological data, it enhances diagnostic accuracy, reduces unnecessary surgeries, and guides optimal patient management.