Advantages of Ultrasound Dopplerography And Optimized ACR TI-RADS System in The Diagnosis of Thyroid Nodules

Abstract

Introduction: Thyroid nodular formations represent a major public health challenge in endemic regions, where high prevalence rates often lead to clinical overdiagnosis and an excessive volume of unnecessary fine-needle aspiration biopsies (FNAB).

                 Objective: To evaluate the clinical, instrumental, and socioeconomic efficacy of combining advanced ultrasound Dopplerography with an automated ACR TI-RADS software algorithm in the risk stratification and differential diagnosis of thyroid nodules in an endemic population.

                 Methods: Cross-sectional cohort data prospectively collected from 140 patients presenting with thyroid nodules in the endemic Khorezm region were analyzed. All participants underwent high-resolution digital B-mode and color/power Doppler ultrasound examinations. Structural features and vascularization types were processed using an automated computer software program based on the ACR TI-RADS pipeline. Software-derived classifications were fully verified against final post-FNAB cytological and post-operative histopathological findings.

                 Results: Nodular formations were highly concentrated in the active workforce demographic aged 40-59 years (45.0%, n=63) and exhibited a profound gender asymmetry, with females affected 7.2 times more frequently than males (123 females vs. 17 males). The Doppler-integrated automated ACR TI-RADS stratification demonstrated a 100% positive predictive value (PPV) for hidden malignancies; all 66 cases categorized as intermediate/high risk (TI-RADS 4 and 5) were histopathologically confirmed as thyroid carcinomas (\(P < 0.001\)). Among the 74 cytologically benign cases, the automated platform successfully eliminated unneeded invasive FNAB procedures in 41.4% (n=58) of the total cohort, reducing direct medical expenditures from 21,000,000 UZS to 12,300,000 UZS and yielding a net diagnostic budget savings of 41.4% (8,700,000 UZS).

                Conclusions: Integrating automated software scoring with color Doppler imaging minimizes clinical physician subjectivity and establishes high diagnostic precision for malignant lesions. This optimized approach safely reduces the socioeconomic and instrumental burden on the healthcare network by preventing unnecessary invasive procedures in more than 41% of the benign patient population.

Keywords:

Thyroid gland, Thyroid nodules, Color Doppler ultrasonography

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