Analysis of the Influence of Age, Size, and Gender on the Relationship Reporting and Data System (ACR TI-RADS) and the Incidence of Thyroid Cancer in Surakarta between Ultrasonography Classified by American College of Radiology Thyroid Imaging

Background: The study aims to see if the age, tumor size and gender factors affect TI-RADS sensitivity. Ultrasonography examination (USG) plays a major role in the initial diagnosis process of a suspected thyroid tumor or cancer to evaluate thyroid nodules. ACR TI-RADS is a classification created with the aim of adapting the BI-RADS concept for thyroid pathology. Several studies have shown a positive correlation between ultrasound results and TI-RADS while on the opposite, several studies have shown decreased sensitivity and specificity of TI-RADS ultrasound classification with respect to increasing age groups. Study on the effect of age on USG and TI-RADS classification has an important role for the improvement of diagnostic procedure.

Objective: To find out whether age, size and gender has an effect on the sensitivity and specificity of USG diagnostics with the TI-RADS classification on the incidence of thyroid cancer in the Surakarta area.

Methods: This study is an analytical observational study with a retrospective design, with the sample population in the form of all results of thyroid ultrasound examination of thyroid cancer patients were carried out at Two General Hospitals in Surakarta to obtain the n=114 of research subjects who match the inclusion criteria and do not match within the predetermined exclusion criteria.

Results: The results of statistical tests carried out on several variables, namely age, gender, and tumor size on the sensitivity and specificity of TI-RADS showed mixed results. After comparing the sensitivity between groups, we used a cutoff point of 55 years and when we compared two groups of patients ( >55 vs ≤55 years old) , we found no statistically significant difference (p=0.496). In the comparison of the sensitivity to the gender variable, which was divided into two groups, the male patient group, and the female patient group with a p-value of 1.000. For comparison of the sensitivity of the size variable, grouped into two categories, patients with small-sized tumor ≤ 1 cm and those with large-sized tumor > 1 cm, a p-value of 0.160 was obtained (Table 10). The p-value for the comparison of specificity of the age variable was 0.062, of the gender variable 1.000, and he size variable 0.208 (Table 11).

Overall, it can be interpreted that the TI-RADS ultrasound examination on some variables above did not show a significant difference (validity) in sensitivity and specificity (p-value > 0.05).

Conclusion: Age, size and gender does not affect the sensitivity and specificity of USG diagnostics with the TI-RADS classification in thyroid cancer patients at Two General Hospital in Surakarta.