Ting Xu1, Ya Wu2, Run-Xin Wu3, Yu-Zhi Zhang4, Jing-Yu Gu2, Xin-Hua Ye5, Wei Tang1, Shu-Hang Xu6, Chao Liu6, Xiao-Hong Wu7. 1. Department of Endocrinology, Jiangsu Province Official Hospital, Nanjing, China. 2. Department of Endocrinology, the First Affiliated Hospital with Nanjing Medical University, Nanjing, China. 3. Nanjing Foreign Languages School, Nanjing, China. 4. Department of Ultrasound, Jiangsu Province Hospital on Integration of Chinese and Western Medicine, Nanjing, China. 5. Department of Ultrasound, the First Affiliated Hospital with Nanjing Medical University, Nanjing, China. 6. Department of Endocrinology, Jiangsu Province Hospital on Integration of Chinese and Western Medicine, Nanjing, China. 7. Department of Endocrinology, the First Affiliated Hospital with Nanjing Medical University, Nanjing, China. drxhwu@njmu.edu.cn.
Abstract
PURPOSE: To validate and compare diagnostic value of three newly-released Thyroid Imaging Reporting and Data Systems (TIRADS) for cancer risk determination. METHODS: Total 2031 patients with 2465 thyroid nodules were recruited for this study. Ultrasound (US) images were categorized based on three TIRADS editions established by Korean Society of Thyroid Radiology (KSThR), European Thyroid Association (ETA) and American College of Radiology (ACR). ROC curves were established to compare diagnostic value. RESULTS: Total 1460 benign and 1005 malignant nodules were enrolled. The malignancy rates of each category in KSThR-TIRADS were 2.8%, 5.1%, 33.7% and 79.6%, respectively. For European-TIRADS, 0, 3.1, 22.8, and 73.5% of nodules categorized as 2 to 5 were malignant. Distribution of carcinomas among ACR-TIRADS categories was 0%, 2.3%, 7.5%, 40.1% and 81.4%, respectively. In terms of diagnostic value, KSThR-TIRADS had highest AUC (0.855) and specificity (87.4%), while lowest (71.4%) sensitivity. ACR-TIRADS showed best sensitivity (96.6%) with lowest specificity (52.9%) and the AUC (0.846) was slightly lower than KSThR-TIRADS. Total 56.1, 45.4, and 37.4% fine-needle aspiration biopsy (FNAB) were recommended by KSThR, ETA and ACR, revealing 42.8%, 44.5% and 53.6% malignant lesions, respectively. The rate of unnecessary FNAB was lowest with the ACR (17.3%), followed by ETA (25.2%) and KSThR (32.1%). CONCLUSION: All these US models showed great value in predicting thyroid malignancy. Among them, KSThR-TIRADS showed the most effective diagnostic performance in specificity, while ACR-TIRADS yielded best sensitivity. As for FNAB criteria, ACR-TIRADS showed the lowest rate of unnecessary FNAB and highest rate of malignancy in FNAB.
PURPOSE: To validate and compare diagnostic value of three newly-released Thyroid Imaging Reporting and Data Systems (TIRADS) for cancer risk determination. METHODS: Total 2031 patients with 2465 thyroid nodules were recruited for this study. Ultrasound (US) images were categorized based on three TIRADS editions established by Korean Society of Thyroid Radiology (KSThR), European Thyroid Association (ETA) and American College of Radiology (ACR). ROC curves were established to compare diagnostic value. RESULTS: Total 1460 benign and 1005 malignant nodules were enrolled. The malignancy rates of each category in KSThR-TIRADS were 2.8%, 5.1%, 33.7% and 79.6%, respectively. For European-TIRADS, 0, 3.1, 22.8, and 73.5% of nodules categorized as 2 to 5 were malignant. Distribution of carcinomas among ACR-TIRADS categories was 0%, 2.3%, 7.5%, 40.1% and 81.4%, respectively. In terms of diagnostic value, KSThR-TIRADS had highest AUC (0.855) and specificity (87.4%), while lowest (71.4%) sensitivity. ACR-TIRADS showed best sensitivity (96.6%) with lowest specificity (52.9%) and the AUC (0.846) was slightly lower than KSThR-TIRADS. Total 56.1, 45.4, and 37.4% fine-needle aspiration biopsy (FNAB) were recommended by KSThR, ETA and ACR, revealing 42.8%, 44.5% and 53.6% malignant lesions, respectively. The rate of unnecessary FNAB was lowest with the ACR (17.3%), followed by ETA (25.2%) and KSThR (32.1%). CONCLUSION: All these US models showed great value in predicting thyroid malignancy. Among them, KSThR-TIRADS showed the most effective diagnostic performance in specificity, while ACR-TIRADS yielded best sensitivity. As for FNAB criteria, ACR-TIRADS showed the lowest rate of unnecessary FNAB and highest rate of malignancy in FNAB.
Authors: Mary C Frates; Carol B Benson; J William Charboneau; Edmund S Cibas; Orlo H Clark; Beverly G Coleman; John J Cronan; Peter M Doubilet; Douglas B Evans; John R Goellner; Ian D Hay; Barbara S Hertzberg; Charles M Intenzo; R Brooke Jeffrey; Jill E Langer; P Reed Larsen; Susan J Mandel; William D Middleton; Carl C Reading; Steven I Sherman; Franklin N Tessler Journal: Radiology Date: 2005-12 Impact factor: 11.105
Authors: Franklin N Tessler; William D Middleton; Edward G Grant; Jenny K Hoang; Lincoln L Berland; Sharlene A Teefey; John J Cronan; Michael D Beland; Terry S Desser; Mary C Frates; Lynwood W Hammers; Ulrike M Hamper; Jill E Langer; Carl C Reading; Leslie M Scoutt; A Thomas Stavros Journal: J Am Coll Radiol Date: 2017-04-02 Impact factor: 5.532
Authors: Paul S Sidhu; Vito Cantisani; Christoph F Dietrich; Odd Helge Gilja; Adrian Saftoiu; Eva Bartels; Michele Bertolotto; Fabrizio Calliada; Dirk-André Clevert; David Cosgrove; Annamaria Deganello; Mirko D'Onofrio; Francesco Maria Drudi; Simon Freeman; Christopher Harvey; Christian Jenssen; Ernst-Michael Jung; Andrea Sabine Klauser; Nathalie Lassau; Maria Franca Meloni; Edward Leen; Carlos Nicolau; Christian Nolsoe; Fabio Piscaglia; Francesco Prada; Helmut Prosch; Maija Radzina; Luca Savelli; Hans-Peter Weskott; Hessel Wijkstra Journal: Ultraschall Med Date: 2018-03-06 Impact factor: 6.548
Authors: Jin Young Kwak; Kyung Hwa Han; Jung Hyun Yoon; Hee Jung Moon; Eun Ju Son; So Hee Park; Hyun Kyung Jung; Ji Soo Choi; Bo Mi Kim; Eun-Kyung Kim Journal: Radiology Date: 2011-07-19 Impact factor: 11.105
Authors: Juan P Brito; Michael R Gionfriddo; Alaa Al Nofal; Kasey R Boehmer; Aaron L Leppin; Carl Reading; Matthew Callstrom; Tarig A Elraiyah; Larry J Prokop; Marius N Stan; M Hassan Murad; John C Morris; Victor M Montori Journal: J Clin Endocrinol Metab Date: 2013-11-25 Impact factor: 5.958
Authors: Roussanka D Kovatcheva; Alexander D Shinkov; Inna D Dimitrova; Ralitsa B Ivanova; Kalin N Vidinov; Radina S Ivanova Journal: Eur Thyroid J Date: 2020-05-18