Jing Zhang1, Bo-Ji Liu1, Hui-Xiong Xu2, Jun-Mei Xu1, Yi-Feng Zhang1, Chang Liu1, Jian Wu1, Li-Ping Sun1, Le-Hang Guo1, Lin-Na Liu1, Xiao-Hong Xu3, Shen Qu4. 1. Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Tongji University School of Medicine Shanghai, China ; Thyroid Institute, Tongji University School of Medicine Shanghai 200072, China. 2. Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Tongji University School of Medicine Shanghai, China ; Thyroid Institute, Tongji University School of Medicine Shanghai 200072, China ; Department of Ultrasound, Guangdong Medical College Affiliated Hospital Zhanjiang, China. 3. Department of Ultrasound, Guangdong Medical College Affiliated Hospital Zhanjiang, China. 4. Thyroid Institute, Tongji University School of Medicine Shanghai 200072, China ; Department of Endocrinology and Metabolism, Shanghai Tenth People's Hospital, Tongji University School of Medicine Shanghai 200072, China.
Abstract
OBJECTIVE: Ultrasound (US) features of solidity, hypoechogenicity or marked hypoechogenicity, microlobulated or irregular margins, microcalcifications, and taller-than-wide shape are suspicious characteristics for thyroid nodules. An US based Thyroid Imaging Reporting and Data System (TI-RADS) is classified based on the number of aforesaid features. TI-RADS category 3 included nodules without any suspicious features, and categories 4a, 4b, 4c, and 5 included nodules with one, two, three or four, or five suspicious US features. The purpose of the study was to prospectively validate the effectiveness of the TI-RADS. METHODS: From October 2011 to June 2013, we prospectively categorized 3980 thyroid nodules (3752 benign and 228 malignant lesions) in 2921 patients using TI-RADS classification. TI-RADS categories 2 and 3 were considered as benign whereas TI-RADS categories 4 and 5 as malignant. The sensitivity, specificity, negative predictive value (NPV), positive predictive value (PPV) and accuracy were calculated. RESULTS: Of the 3980 nodules, 2953 nodules were TI-RADS category 2 (0% malignancy), 466 nodules TI-RADS category 3 (1.3% malignancy), 186 nodules TI-RADS category 4a (4.8% malignancy), 165 nodules TI-RADS category 4b (30.3% malignancy), 188 nodules TI-RADS category 4c (75.5% malignancy), and 22 nodules TI-RADS category 5 (95.5% malignancy). The sensitivity, specificity, PPV, NPV and accuracy were 97%, 90%, 40%, 99%, and 91%, respectively. CONCLUSIONS: TI-RADS classification had great diagnostic value in diagnosing thyroid nodules. The actual probability of malignancy was in accord with the theory risk of malignancy.
OBJECTIVE: Ultrasound (US) features of solidity, hypoechogenicity or marked hypoechogenicity, microlobulated or irregular margins, microcalcifications, and taller-than-wide shape are suspicious characteristics for thyroid nodules. An US based Thyroid Imaging Reporting and Data System (TI-RADS) is classified based on the number of aforesaid features. TI-RADS category 3 included nodules without any suspicious features, and categories 4a, 4b, 4c, and 5 included nodules with one, two, three or four, or five suspicious US features. The purpose of the study was to prospectively validate the effectiveness of the TI-RADS. METHODS: From October 2011 to June 2013, we prospectively categorized 3980 thyroid nodules (3752 benign and 228 malignant lesions) in 2921 patients using TI-RADS classification. TI-RADS categories 2 and 3 were considered as benign whereas TI-RADS categories 4 and 5 as malignant. The sensitivity, specificity, negative predictive value (NPV), positive predictive value (PPV) and accuracy were calculated. RESULTS: Of the 3980 nodules, 2953 nodules were TI-RADS category 2 (0% malignancy), 466 nodules TI-RADS category 3 (1.3% malignancy), 186 nodules TI-RADS category 4a (4.8% malignancy), 165 nodules TI-RADS category 4b (30.3% malignancy), 188 nodules TI-RADS category 4c (75.5% malignancy), and 22 nodules TI-RADS category 5 (95.5% malignancy). The sensitivity, specificity, PPV, NPV and accuracy were 97%, 90%, 40%, 99%, and 91%, respectively. CONCLUSIONS: TI-RADS classification had great diagnostic value in diagnosing thyroid nodules. The actual probability of malignancy was in accord with the theory risk of malignancy.
Entities:
Keywords:
Thyroid imaging reporting and data system (TI-RADS); diagnosis; thyroid nodule; ultrasound
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