{
  "abstract": "Background and objectives Thyroid nodules are common clinical findings, and their detection rate is increasing owing to the widespread use of high-resolution ultrasonography. Accurate risk stratification is essential to avoid unnecessary, invasive procedures. The American College of Radiology Thyroid Imaging Reporting and Data System (ACR-TIRADS) was developed to standardize ultrasound evaluation and guide the need for fine-needle aspiration (FNA). This study aimed to evaluate the correlation between ultrasound-based ACR-TIRADS II and III classifications and fine-needle aspiration cytology (FNAC) results using the Bethesda System. Patients and methods A prospective observational cross-sectional study was conducted at Sulaymaniyah Teaching Hospital between December 2024 and December 2025. Ninety adults with thyroid nodules classified as ACR-TIRADS II (n = 27) or III (n = 63) who underwent ultrasound-guided FNA as part of routine clinical care were included. Cytology was categorized using the Bethesda System. The primary analysis assessed the distribution of Bethesda categories by TIRADS group; Bethesda V-VI was additionally evaluated as a high-risk cytology endpoint rather than as histopathologically confirmed malignancy. Results Bethesda II cytology was more frequent in ACR-TIRADS II than ACR-TIRADS III nodules (88.9% vs 54.0%; Fisher exact P = 0.002). Bethesda V-VI cytology occurred in 3.7% of ACR-TIRADS II and 17.5% of ACR-TIRADS III nodules (Fisher exact P = 0.099). The overall 2×6 ACR-TIRADS-Bethesda System distribution did not reach conventional statistical significance (Pearson χ2 = 10.67, df = 5, P = 0.058). Using ACR-TIRADS III as the positive category for predicting Bethesda V-VI cytology yielded a sensitivity of 91.7% (95% CI 61.5–99.8), specificity of 33.3% (23.1–44.9), PPV of 17.5% (9.1–29.1), NPV of 96.3% (81.0–99.9), and overall accuracy of 41.1% (30.8–52.0). Conclusions In this selected cohort of biopsied low-risk nodules, TIRADS II was predominantly associated with benign cytology, while TIRADS III showed a higher proportion of Bethesda V-VI outcomes. These findings support the value of ACR-TIRADS as a risk-stratification framework, but they should not be interpreted as evidence to omit or mandate FNA outside established size and clinical criteria because histopathological confirmation and longitudinal follow-up were not available.",
  "abstract_shown": true,
  "affiliations": [
    "Clinical Radiology and Medical Imaging department, Clinical Radiology and Medical Imaging, Kurdistan Higher Council of Medical Specialties, Sulaymaniyah Teaching Hospital/Radiology Center."
  ],
  "article_type": null,
  "arxiv": null,
  "author_total": 2,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Tara Roshen"
    },
    {
      "affs": [
        0
      ],
      "name": "Naser Abdullah Mohammed"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/e9ft7a14dk1sb.bib",
  "cited_by": 0,
  "doi": "10.1186/s43055-026-01887-w",
  "fulltext_url": "https://doi.org/10.1186/s43055-026-01887-w",
  "id": "e9ft7a14dk1sb",
  "issns": [
    "2090-4762",
    "0378-603X"
  ],
  "landing_url": "https://doi.org/10.1186/s43055-026-01887-w",
  "language": "en",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "journal",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "lcc",
      "R895-920"
    ],
    [
      "openalex",
      "2712|Thyroid Cancer Diagnosis and Treatment"
    ]
  ],
  "openalex": "W7223089018",
  "pdf_url": "https://link.springer.com/content/pdf/10.1186/s43055-026-01887-w.pdf",
  "pmcid": null,
  "pmid": null,
  "published": "2026-10-25",
  "publisher": "SpringerOpen",
  "ris": "https://research.draconitic.com/paper/e9ft7a14dk1sb.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T13:45:41Z",
      "native_id": "1bd6a0a3d553407fb2219d854a8af6e6",
      "source": "doaj",
      "url": "https://doi.org/10.1186/s43055-026-01887-w"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2712|Thyroid Cancer Diagnosis and Treatment",
      "subfield": "endocrinology-metabolism"
    }
  ],
  "title": "Correlation between ultrasound findings of thyroid imaging reporting and data system II and III thyroid nodules and fine-needle aspiration results",
  "title_text": "Correlation between ultrasound findings of thyroid imaging reporting and data system II and III thyroid nodules and fine-needle aspiration results",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T13:45:41Z",
  "url": "https://research.draconitic.com/paper/e9ft7a14dk1sb",
  "venue": "The Egyptian Journal of Radiology and Nuclear Medicine",
  "versions": []
}