ASSESSMENT OF MALIGNANT THYROID NODULE DETECTION USING ULTRASOUND REPORTING SYSTEMS AND ASSOCIATED FACTORS AMONG THYROID NODULE PATIENTS AT SELECTED PUBLIC HOSPITALS IN ADDIS ABABA, ETHIOPIA,

Abstract

Background: The ultimate goal of diagnostic assessment of thyroid nodules is to accurately identify malignancy. Ultrasound is widely used due to its accessibility. However, cytology remains the gold standard and previous studies shown potential inconsistency between ultrasound and cytology findings its lead to the patient for unnecessary FNA. Based on researcher knowledge its first study conducted in Ethiopia. Objective: The aim of this study was to assess malignant thyroid nodule detection using ultrasound reporting systems and associated factors among thyroid nodule patients at selected public hospitals in Addis Ababa, Ethiopia Methods: Facility based cross-sectional study was conducted among three randomly selected public hospitals in Addis Ababa Ethiopia, from October 15 to November 15, 2024. A simple random sampling technique was used to select 294 study respondents. Data was extracted from medical records using a structured checklist and analyzed using SPSS Version 25. Descriptive statistics were initially computed. Diagnostic accuracy tests with their 95% CI were conducted. Finally, multivariable logistic regression analysis was fitted to identify factors associated with the malignant thyroid nodule detection. P-value <0.05 with 95% CI was considered statistical significant association. Result: The overall proportion of malignant thyroid nodule detection by ultrasound were 87% (95%CI 82-90%). Adjusted analysis showed that the odds of malignant thyroid nodule detection were significantly associated with hypo echogenicity (AOR = 4.18, 95% CI = 1.40 12.50), taller than wider shape (AOR = 2.65, 95% CI = 1.16-6.08), size of the nodule (AOR = 2.46, 95% CI = 1.14-5.28), central vascularity (AOR = 0.33, 95% CI = 0.45-0.76), and isthmus location (AOR = 3.07, 95% CI = 1.11-8.49). Conclusion and recommendations: Ultrasound feature such as hypo echogenicity, taller than-wide shape, and size of nodule greater than 2cm, central vascularity and isthmus location were significantly associated with malignant thyroid nodule detection. The thyroid imaging reporting and data system is a reliable tool for predicts thyroid nodule malignancy so those hospital in Addis Ababa use as a clinical guideline for evaluating thyroid nodules.