Introduction.

Thyroid nodules are common and distinguishing benign from malignant lesions, especially in non-toxic nodules, remains a clinical challenge.

Objective.

This study aimed to assess the diagnostic performance of ultrasound-based criteria in a Mexican population.

Method.

A cross-sectional study was conducted at a secondary-care hospital. Adults with palpable, non-toxic thyroid nodules underwent fine-needle aspiration and thyroid ultrasound. The nodules were classified using American College of Radiology Thyroid Imaging Reporting and Data System (ACR TI-RADS), and diagnostic metrics were calculated.

Results.

Data from 59 patients were analyzed. Of the nodules assessed, 15.3% were malignant, with 44.4% initially classified as benign by TI-RADS. The sensitivity of TI-RADS ≥ 3 for detecting malignancy was 33.3% (95% CI 7.5-70.1%), while specificity was 46.0% (95% CI 31.8-60.7%). The receiver operating characteristic (ROC) area under the curve (AUC) was 0.64, indicating suboptimal diagnostic performance.

Conclusion.

TI-RADS showed limited accuracy in detecting malignant thyroid nodules within our Mexican population, highlighting the need for region-specific refinement. Future research should focus on adapting classification criteria to reflect local pathological patterns, integrating advanced imaging modalities, and conducting prospective validation of new diagnostic tools. These improvements are essential to enhance risk stratification and support more precise clinical decision-making across diverse populations.

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