Malignancy risk stratification of thyroid nodules: comparisons of four ultrasound Thyroid Imaging Reporting and Data Systems in surgically resected nodules

Due to the widespread use of ultrasound, small thyroid nodules (TNs) ≤ 10 mm are common findings. Standardized approaches for the risk stratification of TNs with Thyroid Imaging Reporting and Data Systems (TIRADS) were evaluated for the clinical routine. With TIRADS, the risk of malignancy in TNs is calculated by scoring the number or combination of suspicious ultrasound features, leading to recommendations for further diagnostic steps. However, there are only scarce data on the performance of TIRADS for small TNs. The aim was to compare three different TIRADS for risk stratification of small TNs in routine clinical practice. We conducted a retrospective cohort analysis of TNs ≤ 10 mm and their available histology. Nodules were classified according to three different TIRADS. In the study, 140 patients (n = 113 female) with 145 thyroid nodules (n = 76 malignant) were included. Most of the malignant nodules were papillary carcinoma (97%), and the remaining 3% were medullary carcinoma. For all tested TIRADS, the prevalence of malignancy rose with increasing category levels. The highest negative predictive value was found for ACR TI-RADS and the highest positive predictive value for Kwak-TIRADS. All tested variants of TIRADS showed comparable diagnostic performance for the risk stratification of small TNs. TIRADS seems to be a promising tool to reliably assess the risk of malignancy of small TNs.

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Shear wave elastography combined with the thyroid imaging reporting and data system for malignancy risk stratification in thyroid nodules

Oncotarget ◽

10.18632/oncotarget.15018 ◽

2017 ◽

Vol 8 (26) ◽

pp. 43406-43416 ◽

Cited By ~ 7

Author(s):

Zhao Liu ◽

Hui Jing ◽

Xue Han ◽

Hua Shao ◽

Yi-Xin Sun ◽

...

Keyword(s):

Risk Stratification ◽

Shear Wave ◽

Thyroid Nodules ◽

Shear Wave Elastography ◽

Data System ◽

Malignancy Risk ◽

Thyroid Imaging

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Virtual Touch Tissue Imaging and Quantification (VTIQ) combined with the American College of Radiology Thyroid Imaging Reporting and Data System (ACR TI-RADS) for malignancy risk stratification of thyroid nodules

Clinical Hemorheology and Microcirculation ◽

10.3233/ch-180477 ◽

2019 ◽

Vol 72 (3) ◽

pp. 279-291 ◽

Cited By ~ 7

Author(s):

Xiang Li ◽

Xiu-Juan Hou ◽

Lin-Yao Du ◽

Jia-Qi Wu ◽

Luo Wang ◽

...

Keyword(s):

Risk Stratification ◽

Thyroid Nodules ◽

Data System ◽

Tissue Imaging ◽

Malignancy Risk ◽

Thyroid Imaging ◽

Virtual Touch Tissue Imaging

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Malignancy Risk Stratification in Thyroid Nodules with Nondiagnostic Results at Cytologic Examination: Combination of Thyroid Imaging Reporting and Data System and the Bethesda System

Radiology ◽

10.1148/radiol.14140359 ◽

2015 ◽

Vol 274 (1) ◽

pp. 287-295 ◽

Cited By ~ 47

Author(s):

Hee Jung Moon ◽

Eun-Kyung Kim ◽

Jung Hyun Yoon ◽

Jin Young Kwak

Keyword(s):

Risk Stratification ◽

Thyroid Nodules ◽

Data System ◽

Cytologic Examination ◽

Malignancy Risk ◽

Thyroid Imaging ◽

Bethesda System ◽

The Bethesda System

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Impact of the Hypoechogenicity Criteria on Thyroid Nodule Malignancy Risk Stratification Performance by Different TIRADS Systems

Cancers ◽

10.3390/cancers13215581 ◽

2021 ◽

Vol 13 (21) ◽

pp. 5581

Author(s):

Nina Malika Popova ◽

Maija Radzina ◽

Peteris Prieditis ◽

Mara Liepa ◽

Madara Rauda ◽

...

Keyword(s):

Risk Stratification ◽

Diagnostic Accuracy ◽

Thyroid Nodules ◽

Needle Aspiration ◽

Data Systems ◽

Malignancy Risk ◽

Risk Of Malignancy ◽

Bethesda System ◽

Sensitivity Specificity ◽

The Bethesda System

Background: Various Thyroid Imaging and Reporting data systems (TIRADS) are used worldwide for risk stratification of thyroid nodules. Their sensitivity is high, while the specificity is suboptimal. The aim of the study was to compare several TIRADS systems and evaluate the effect of hypoechogenicity as a sign of risk of malignancy on the overall assessment of diagnostic accuracy. Methods: The prospective study includes 274 patients with 289 thyroid nodules to whom US and risk of malignancy were assessed according to four TIRADS systems—European (EU-TIRADS), Korean (K-TIRADS), TIRADS by American College of Radiology (ACR TIRADS), and modified Kwak et al. TIRADS (L-TIRADS) systems, in which mild hypoechogenicity is not included in malignancy risk suggestive signs. For all thyroid nodules, a fine needle aspiration (FNA) biopsy was performed and evaluated according to the Bethesda system. For all systems, diagnostic accuracy was calculated. Results: Assessing the echogenicity of the thyroid nodules: from 81 of isoechogenic nodules, 2 were malignant (2.1%), from 151 mild hypoechogenic, 18 (12%) were malignant, and from 48 marked hypoechogenic nodules, 16 (33%) were malignant. In 80 thyroid nodules, mild hypoechogenicity was the only sign of malignancy and none appeared malignant. Assessing various TIRADS systems on the same cohort, sensitivity, specificity, PPV, NPV, and accuracy, firstly for EU-TIRADS, they were 97.2%; 39.9%; 18.7%; 99.0%, and 73.3%, respectively; for K-TIRADS they were 97.2%; 46.6%; 20.6%; 99.2%, and 53.9%; for ACR-TIRADS they were 97.2%; 41.1%, 19.0%; 99.0%, and 48.0%, respectively; finally, for L-TIRADS they were 80.6%; 72.7%; 29.6%; 96.3%, and 73.3%. Conclusions: This comparative research has highlighted that applying different TIRADS systems can alter the number of necessary biopsies by re-categorization of the thyroid nodules. The main pattern that affected differences was inconsistent hypoechogenicity interpretation, giving the accuracy superiority to the systems that raise the malignancy risk with marked hypoechogenicity, at the same time with minor compensation for sensitivity.

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