Thyroid lesions often cause unnecessary patient anxiety and lead to financial burden on patients who undergo invasive tests for clinically unimportant lesions.USG with Doppler interrogation is a noninvasive method of  selecting  the most suspicious lesion (on  the  basis  of  USG features) by avoiding  needless  biopsies for  every nodule . The study aims at assessing the role of USG and Color Doppler in the   risk stratification of thyroid lesions based on standard lexicon: ACR-TIRADS 2017 and correlating findings with histopathological examination. Secondly, guiding decision whether to perform FNAC/biopsy or follow up by interval USG. Thirdly, in improving prognosis and survival rate by detecting malignancy at an early stage. 125 adult patients with thyroid lesions were evaluated from March 2018 to August 2019 with ultrasonography and color Doppler and categorized as per ACR-TIRADS 2017 classification. The results in each TIRADS category were compared with histopathological examination. Combining TIRADS 2 and 3 as probably benign ultrasound findings and TIRADS 4 and 5 as probably malignant , sensitivity, specificity, positive predictive value , negative  predictive value and accuracy were 96.8%, 63.9%, 73.8%, 95.0% and 80.8% respectively for TIRADS classification when compared with the cytohistopathological results. Doppler findings of intranodular /central/ central > peripheral pattern of vascularity favouring malignancy correlated well with histopathological results. Thus, USG can be used as a reliable modality for early detection of thyroid lesions and in excluding malignancy thereby obviating costly interventions for nodules that can be safely followed up by interval USG.

Keywords: USG, Thyroid lesions, Color Doppler, ACR TIRADS 2017, FNAC, Histopathological.

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