Supeng Huang1, Ning Meng1, Mengting Pan2, Bo Yu2, Juan Liu3, Kailin Deng3, Mingrong Hu1, Hongwei Zhou1, Chao Qin1. 1. Department of Thyroid and Breast Surgery, The Affiliated Hospital of Hangzhou Normal University Hangzhou, China. 2. Department of Ultrasound, The Affiliated Hospital of Hangzhou Normal University Hangzhou, China. 3. Department of Pathology, The Affiliated Hospital of Hangzhou Normal University Hangzhou, China.
Abstract
OBJECTIVE: To explore the value of the KWAK Thyroid Imaging Reporting and Data System (KWAK-TIRADS), elasticity score (ES), and Bethesda System for Reporting Thyroid Cytopathology (BSRTC) in the diagnosis of suspicious thyroid nodules. MATERIALS AND METHODS: The study included 392 cases of TI-RADS category 4 thyroid nodules that underwent thyroidectomy between January 2017 and October 2019. All patients underwent ultrasonography, ultrasound elastography, and fine-needle aspiration cytology (FNAC) before surgery. The nodules were classified into different categories based on the KWAK-TIRADS, ES, and BSRTC. Patients were divided into two groups based on postoperative pathological characteristics. The sensitivity (Se), specificity (Sp), and area under the receiver operating characteristic (ROC) curve were calculated. Student's t-test and Pearson chi-square test were used to compare diagnostic performance. RESULTS: There were 159 patients in the benign group and 233 in the malignant group. The percentage of malignant nodules in KWAK-TIRADS categories 4a, 4b, and 4c were 44.3%, 64.8%, and 92.9%, respectively. The percentages of malignant nodules in ES 2, 3, 4, and 5 were 0%, 37.1%, 93.8%, and 100%, respectively. The percentage of malignant nodules in BSRTC levels I, II, III, IV, V and VI were 57.1%, 2.8%, 9.9%, 76.6%, 99.1%, and 100%, respectively. Among those methods, the BSRTC had better diagnostic efficiency than the KWAK-TIRADS and ES (Sp 81.1%, Se 93.6%, and AUC 0.918, P<0.01). Among the combined methods, KWAK-TIRADS+ES+BSRTC was more effective than KWAK-TIRADS+ES, KWAK-TIRADS+BSRTC, and ES+BSRTC (Sp 93.7%, Se 91.4%, and AUC 0.967, P<0.01). CONCLUSION: The combination of KWAK-TIRADS, ES, and BSRTC can improve the accuracy of identifying category 4 thyroid nodules. IJCEP
OBJECTIVE: To explore the value of the KWAK Thyroid Imaging Reporting and Data System (KWAK-TIRADS), elasticity score (ES), and Bethesda System for Reporting Thyroid Cytopathology (BSRTC) in the diagnosis of suspicious thyroid nodules. MATERIALS AND METHODS: The study included 392 cases of TI-RADS category 4 thyroid nodules that underwent thyroidectomy between January 2017 and October 2019. All patients underwent ultrasonography, ultrasound elastography, and fine-needle aspiration cytology (FNAC) before surgery. The nodules were classified into different categories based on the KWAK-TIRADS, ES, and BSRTC. Patients were divided into two groups based on postoperative pathological characteristics. The sensitivity (Se), specificity (Sp), and area under the receiver operating characteristic (ROC) curve were calculated. Student's t-test and Pearson chi-square test were used to compare diagnostic performance. RESULTS: There were 159 patients in the benign group and 233 in the malignant group. The percentage of malignant nodules in KWAK-TIRADS categories 4a, 4b, and 4c were 44.3%, 64.8%, and 92.9%, respectively. The percentages of malignant nodules in ES 2, 3, 4, and 5 were 0%, 37.1%, 93.8%, and 100%, respectively. The percentage of malignant nodules in BSRTC levels I, II, III, IV, V and VI were 57.1%, 2.8%, 9.9%, 76.6%, 99.1%, and 100%, respectively. Among those methods, the BSRTC had better diagnostic efficiency than the KWAK-TIRADS and ES (Sp 81.1%, Se 93.6%, and AUC 0.918, P<0.01). Among the combined methods, KWAK-TIRADS+ES+BSRTC was more effective than KWAK-TIRADS+ES, KWAK-TIRADS+BSRTC, and ES+BSRTC (Sp 93.7%, Se 91.4%, and AUC 0.967, P<0.01). CONCLUSION: The combination of KWAK-TIRADS, ES, and BSRTC can improve the accuracy of identifying category 4 thyroid nodules. IJCEP