Combined preoperative thyroglobulin and ACR-TIRADS assessment: implications for fine-needle aspiration biopsy strategy and thyroid cancer diagnosis

Purpose: The aim of this study is to evaluate the relationship of Thyroglobulin (Tg) with the American College of Radiology Thyroid Imaging Reporting and Data System (ACR-TIRADS) and Bethesda and its correlation with malignancy.Materials and Methods: The study included 603 cases. Ultrasonography (US), fine needle aspiration biopsy (FNAB), Tg and anti-Tg results were evaluated retrospectively. Nodules were scored according to the ACR-TIRADS. FNAB results were evaluated according to the Bethesda. The relationship between Tg levels, ACR-TIRADS, and FNAB results was evaluated to determine the risk of thyroid malignancy.Results: The mean age of cases was 50.98±13.73 (min-max: 18-79). 85.1% of the patients were female. Tg was statistically significantly higher in malignant patients (Bethesda 6). In the ROC analysis, the optimum cut-off value for Tg in predicting malignancy was found to be 245 ng/dL. Mean Tg levels were statistically significantly higher in the TIRADS 4, 5 groups than in the TIRADS 2 and 3 groups.Conclusion: Results showed that Tg is elevated in thyroid nodular disease, especially in malignant nodules. The Tg levels increased in parallel with the ACR-TIRADS malignancy-risk score. If these results are supported by other studies, the evaluation of Tg together with ACR-TIRADS may make an additional contribution to the FNAB decision and the prediction of thyroid malignancies.