Flavia Magri1,2, Spyridon Chytiris1, Laura Croce1,2,3, Martina Molteni1,2, Giulia Bendotti1,2, Giovanni Gruosso2, Samuel Tata Ngnitejeu4, Manuela Agozzino5, Mario Rotondi1,2, Luca Chiovato1,2. 1. Istituti Clinici Scientifici Maugeri IRCCS, Unit of Internal Medicine and Endocrinology, Laboratory for Endocrine Disruptors, Pavia, Italy. 2. Department of Internal Medicine and Therapeutics, University of Pavia, Pavia, Italy. 3. Ph.D. course in Experimental Medicine, University of Pavia, Pavia, Italy. 4. Department of General and Minimally Invasive Surgery, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy. 5. Istituti Clinici Scientifici Maugeri IRCCS, Pathology Unit, Pavia, Italy.
Abstract
OBJECTIVE: The ultrasonographic scores EU TI-RADS and ACR TI-RADS were introduced to give the clinicians indications for fine needle aspiration cytology (FNAC). The predictive role of these scores was never evaluated and compared in a surgical series of patients. The aim of this study was to evaluate the ex post diagnostic accuracy of EU TI-RADS and ACR TI-RADS in a real-life series of thyroidectomized patients and to evaluate the 'missing' thyroid cancer following the operational indications of these scores. DESIGN: Retrospective monocentric cohort study. METHODS: In total, 255 patients (harboring 304 nodules) undergoing thyroidectomy for benign and malignant thyroid conditions were enrolled. The prevalence of thyroid malignancy for each class of ACR TI-RADS and EU TI-RADS, their diagnostic accuracy, the number of 'unnecessary' FNAC and the number of 'missed' cancers were evaluated. RESULTS: ACR TI-RADS and EU TI-RADS score had similar and satisfactory accuracy values for predicting thyroid malignancy (AUC: 0.835 for ACR TI-RADS vs 0.827 for EU TI-RADS). The ACR TI-RADS and EU TI-RADS categories (suspicious vs non-suspicious), age, sex and presence of a single nodule significantly and independently predicted the presence of malignancy in a logistic regression model. An ex post analysis according to the indications for FNAC for each score indicated that 31 and 16 cases of cancer would have been missed by ACR TI-RADS and EU TI-RADS scores, respectively. CONCLUSIONS: ACR TI-RADS and EU TI-RADS display a good performance in predicting thyroid cancer when histology is taken as reference standard, but additional clinical judgement is required to decide the indication for FNAC.
OBJECTIVE: The ultrasonographic scores EU TI-RADS and ACR TI-RADS were introduced to give the clinicians indications for fine needle aspiration cytology (FNAC). The predictive role of these scores was never evaluated and compared in a surgical series of patients. The aim of this study was to evaluate the ex post diagnostic accuracy of EU TI-RADS and ACR TI-RADS in a real-life series of thyroidectomized patients and to evaluate the 'missing' thyroid cancer following the operational indications of these scores. DESIGN: Retrospective monocentric cohort study. METHODS: In total, 255 patients (harboring 304 nodules) undergoing thyroidectomy for benign and malignant thyroid conditions were enrolled. The prevalence of thyroid malignancy for each class of ACR TI-RADS and EU TI-RADS, their diagnostic accuracy, the number of 'unnecessary' FNAC and the number of 'missed' cancers were evaluated. RESULTS: ACR TI-RADS and EU TI-RADS score had similar and satisfactory accuracy values for predicting thyroid malignancy (AUC: 0.835 for ACR TI-RADS vs 0.827 for EU TI-RADS). The ACR TI-RADS and EU TI-RADS categories (suspicious vs non-suspicious), age, sex and presence of a single nodule significantly and independently predicted the presence of malignancy in a logistic regression model. An ex post analysis according to the indications for FNAC for each score indicated that 31 and 16 cases of cancer would have been missed by ACR TI-RADS and EU TI-RADS scores, respectively. CONCLUSIONS: ACR TI-RADS and EU TI-RADS display a good performance in predicting thyroid cancer when histology is taken as reference standard, but additional clinical judgement is required to decide the indication for FNAC.
Authors: Lorenzo Scappaticcio; Pierpaolo Trimboli; Sergio Iorio; Maria Ida Maiorino; Miriam Longo; Laura Croce; Marcello Filograna Pignatelli; Sonia Ferrandes; Immacolata Cozzolino; Marco Montella; Andrea Ronchi; Renato Franco; Mario Rotondi; Giovanni Docimo; Katherine Esposito; Giuseppe Bellastella Journal: Front Endocrinol (Lausanne) Date: 2022-09-15 Impact factor: 6.055
Authors: T J Marini; S L Weiss; A Gupta; Y T Zhao; T M Baran; B Garra; I Shafiq; D C Oppenheimer; M S Egoavil; R L Ortega; R A Quinn; J Kan; A M Dozier; L Tamayo; C Carlotto; B Castaneda Journal: J Endocrinol Invest Date: 2021-05-10 Impact factor: 4.256