Mohammad Abd Alkhalik Basha1, Ahmad Abdullah Alnaggar2, Rania Refaat3, Ahmed Mohamed El-Maghraby4, Mona Mohammed Refaat5, Marwa E Abd Elhamed6, Ahmed A El-Hamid M Abdalla7, Sameh Abdelaziz Aly8, Amr Shaaban Hanafy9, Abd El Motaleb Mohamed10, Amira Hamed Mohamed Afifi11, Ola Harb12. 1. Department of Radio-diagnosis, Zagazig University, Zagazig, Egypt. Electronic address: Mohammad_basha76@yahoo.com. 2. Department of Radio-diagnosis, Zagazig University, Zagazig, Egypt. Electronic address: naggar2002us@yahoo.com. 3. Department of Radio-diagnosis, Ain Shams University, Cairo, Egypt. Electronic address: raniarefaat_1977@hotmail.com. 4. Department of Radio-diagnosis, Zagazig University, Zagazig, Egypt. Electronic address: dr_elmaghraby80@yahoo.com. 5. Department of Radio-diagnosis, Zagazig University, Zagazig, Egypt. Electronic address: refaatmona96@gmail.com. 6. Department of Radio-diagnosis, Zagazig University, Zagazig, Egypt. Electronic address: dr.meroelsaed34@gmail.com. 7. Department of Radio-diagnosis, Zagazig University, Zagazig, Egypt. Electronic address: ahmedzagazig@yahoo.com. 8. Department of Radio-diagnosis, Benha University, Benha, Egypt. Electronic address: drsamehaly75@gmail.com. 9. Department of Internal medicine, Zagazig University, Zagazig, Egypt. Electronic address: dr_amr_hanafy@yahoo.com. 10. Department of Clinical Oncology, Zagazig University, Zagazig, Egypt. Electronic address: Abdelmotalabmohamed@yahoo.com. 11. Department of Clinical Pathology, Zagazig University, Zagazig, Egypt. Electronic address: Amira_hamed79@hotmail.com. 12. Department of Pathology, Zagazig University, Zagazig, Egypt. Electronic address: olaharb2015@gmail.com.
Abstract
PURPOSE: To assess diagnostic validity and reproducibility of Thyroid Imaging Reporting and Data System (TI-RADS) for interpretation of thyroid nodules by thyroid ultrasonography (US). METHOD: A prospective multicentre study initially included 557 patients with clinically suspected thyroid nodules. After exclusion, a final cohort of 380 patients with 948 thyroid nodules detected by US were enrolled. Based on American College of Radiology (ACR) TI-RADS, three radiologists analysed all US examinations independently and assigned a TI-RADS category to each thyroid nodule. The final diagnosis was based on cytology which was used as reference standard for calculating diagnostic performance of TI-RADS for predicting malignant thyroid nodules. The Fleiss and weighted kappa (κ) statistics were applied to assess inter-observer agreement of morphological features and TI-RADS scoring results for thyroid nodules. Additionally, we made a simple screening among referring clinicians to assess the clinical response to application of TI-RADS. RESULTS: A total of 948 thyroid nodules were evaluated; 136 (14.3%) were malignant, and 812 (85.7%) were benign. The papillary carcinoma was the most common malignant thyroid nodules (81.6%). The best cut-off value for predicting malignant thyroid nodules was > TR3. On a lesion-based analysis, the TI-RADS had a sensitivity, specificity, and an accuracy of 98.3%, 90.9%, and 92.1%, respectively when regarding those thyroid nodules classified as > TR3 for predicting malignancy. The inter-observer agreement of the TI-RADS category was good (κ = 0.636). Ninety percent of referring clinicians accept TI-RADS. CONCLUSIONS: TI-RADS improves diagnostic performance of US for predicting malignant thyroid nodules with high validity and high reproducibility.
PURPOSE: To assess diagnostic validity and reproducibility of Thyroid Imaging Reporting and Data System (TI-RADS) for interpretation of thyroid nodules by thyroid ultrasonography (US). METHOD: A prospective multicentre study initially included 557 patients with clinically suspected thyroid nodules. After exclusion, a final cohort of 380 patients with 948 thyroid nodules detected by US were enrolled. Based on American College of Radiology (ACR) TI-RADS, three radiologists analysed all US examinations independently and assigned a TI-RADS category to each thyroid nodule. The final diagnosis was based on cytology which was used as reference standard for calculating diagnostic performance of TI-RADS for predicting malignant thyroid nodules. The Fleiss and weighted kappa (κ) statistics were applied to assess inter-observer agreement of morphological features and TI-RADS scoring results for thyroid nodules. Additionally, we made a simple screening among referring clinicians to assess the clinical response to application of TI-RADS. RESULTS: A total of 948 thyroid nodules were evaluated; 136 (14.3%) were malignant, and 812 (85.7%) were benign. The papillary carcinoma was the most common malignant thyroid nodules (81.6%). The best cut-off value for predicting malignant thyroid nodules was > TR3. On a lesion-based analysis, the TI-RADS had a sensitivity, specificity, and an accuracy of 98.3%, 90.9%, and 92.1%, respectively when regarding those thyroid nodules classified as > TR3 for predicting malignancy. The inter-observer agreement of the TI-RADS category was good (κ = 0.636). Ninety percent of referring clinicians accept TI-RADS. CONCLUSIONS: TI-RADS improves diagnostic performance of US for predicting malignant thyroid nodules with high validity and high reproducibility.
Authors: Katarzyna Dobruch-Sobczak; Zbigniew Adamczewski; Marek Dedecjus; Andrzej Lewiński; Bartosz Migda; Marek Ruchała; Anna Skowrońska-Szcześniak; Ewelina Szczepanek-Parulska; Klaudia Zajkowska; Agnieszka Żyłka Journal: J Ultrason Date: 2022-04-27
Authors: Saad M Alqahtani; Sultan F Alanesi; Waqas S Mahmood; Yassin M Moustafa; Laila M Moharram; Nawaf F Alharthi; Attiya M Alzahrani; Yousef S Alalawi Journal: Saudi Med J Date: 2022-05 Impact factor: 1.422