Ultrasound Real-Time Tissue Elastography Improves the Diagnostic Performance of the ACR Thyroid Imaging Reporting and Data System in Differentiating Malignant from Benign Thyroid Nodules: A Summary of 1525 Thyroid Nodules

Background. To explore the correlation between the ultrasound elasticity score (ES) of real-time tissue elastography (RTE) and the malignant risk stratification of the Thyroid Imaging Reporting and Data System (TI-RADS) and to evaluate the added value of RTE to TI-RADS in differentiating malignant nodules from benign ones. Methods. A total of 1,498 patients (885 women and 613 men; mean age of 43.5 ± 12.4 years) with 1,525 confirmed thyroid nodules (D = maximum diameter, D ≤ 2.5 cm) confirmed by fine-needle aspiration (FNA) and/or surgery were included. The nodules were divided into four groups based on their sizes (D ≤ 0.5 cm, 0.5 < D ≤ 1.0 cm, 1.0 < D ≤ 2.0 cm, and 2.0 < D ≤ 2.5 cm). We assigned an ES of RTE and malignant risk stratification of the TI-RADS category to each nodule. The correlation between the ES of RTE and the malignant risk stratification of TI-RADS category was analyzed by the Spearman’s rank correlation. The diagnostic performances of RTE, TI-RADS, and their combination were compared by the receiver operator characteristic (ROC) analysis. Results. The ES of RTE and the malignant risk stratification of TI-RADS showed a strong correlation in the size intervals of 0.5 < D ≤ 1.0 cm, 1.0 < D ≤ 2.0 cm, and 2.0 < D ≤ 2.5 cm (r = 0.768, 0.711, and 0.743, respectively). The diagnostic performance of their combination for each size interval was always better than RTE or TI-RADS alone (for all, P<0.001). Conclusions. Overall, The ES of RTE was strongly correlated with the malignant risk stratification of TI-RADS. The diagnostic performance of the combination of RTE and TI-RADS outperformed RTE or TI-RADS alone. Therefore, RTE may be an adjunctive tool to the current TI-RADS system for differentiating malignant from benign thyroid nodules.

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Malignancy risk of initially benign thyroid nodules: validation with various Thyroid Imaging Reporting and Data System guidelines

European Radiology ◽

10.1007/s00330-018-5566-0 ◽

2018 ◽

Vol 29 (1) ◽

pp. 133-140 ◽

Cited By ~ 10

Author(s):

Su Min Ha ◽

Jung Hwan Baek ◽

Young Jun Choi ◽

Sae Rom Chung ◽

Tae Yon Sung ◽

...

Keyword(s):

Thyroid Nodules ◽

Data System ◽

Malignancy Risk ◽

Thyroid Imaging ◽

Benign Thyroid Nodules ◽

Benign Thyroid

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Computer-Aided Diagnostic System for Thyroid Nodules on Ultrasonography: Diagnostic Performance Based on the Thyroid Imaging Reporting and Data System Classification and Dichotomous Outcomes

American Journal of Neuroradiology ◽

10.3174/ajnr.a6922 ◽

2020 ◽

Author(s):

M. Han ◽

E.J. Ha ◽

J.H. Park

Keyword(s):

Diagnostic Performance ◽

Thyroid Nodules ◽

Diagnostic System ◽

Data System ◽

Thyroid Imaging ◽

Computer Aided ◽

Dichotomous Outcomes

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Diagnostic Performance of Different Thyroid Imaging Reporting and Data Systems (Kwak-TIRADS, EU-TIRADS and ACR TI-RADS) for Risk Stratification of Small Thyroid Nodules (≤10 mm)

Journal of Clinical Medicine ◽

10.3390/jcm9010236 ◽

2020 ◽

Vol 9 (1) ◽

pp. 236 ◽

Cited By ~ 3

Author(s):

Simone Schenke ◽

Rigobert Klett ◽

Philipp Seifert ◽

Michael C. Kreissl ◽

Rainer Görges ◽

...

Keyword(s):

Risk Stratification ◽

Predictive Value ◽

Diagnostic Performance ◽

Thyroid Nodules ◽

Cohort Analysis ◽

Medullary Carcinoma ◽

Data Systems ◽

Thyroid Imaging ◽

Promising Tool ◽

Risk Of Malignancy

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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Erratum to “Inter-exam agreement and diagnostic performance of the Korean Thyroid Imaging Reporting and Data System for thyroid nodule assessment: Real-time versus static ultrasonography” [Eur. J. Radiol. 98 (2018) 14–19]

European Journal of Radiology ◽

10.1016/j.ejrad.2018.02.007 ◽

2018 ◽

Vol 101 ◽

pp. 193 ◽

Cited By ~ 1

Author(s):

Jung Min Bae ◽

Soo Yeon Hahn ◽

Jung Hee Shin ◽

Eun Young Ko

Keyword(s):

Thyroid Nodule ◽

Real Time ◽

Diagnostic Performance ◽

Data System ◽

Thyroid Imaging

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Risk Stratification of Thyroid Nodules Using the Thyroid Imaging Reporting and Data System (TIRADS): The Omission of Thyroid Scintigraphy Increases the Rate of Falsely Suspected Lesions

Journal of Nuclear Medicine ◽

10.2967/jnumed.118.211912 ◽

2018 ◽

Vol 60 (3) ◽

pp. 342-347 ◽

Cited By ~ 14

Author(s):

Simone Schenke ◽

Philipp Seifert ◽

Michael Zimny ◽

Thomas Winkens ◽

Ina Binse ◽

...

Keyword(s):

Risk Stratification ◽

Thyroid Nodules ◽

Data System ◽

Thyroid Scintigraphy ◽

Thyroid Imaging

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Assessment of perinodular stiffness in differentiating malignant from benign thyroid nodules

Endocrine Connections ◽

10.1530/ec-21-0034 ◽

2021 ◽

Author(s):

Lei Hu ◽

Xiao Liu ◽

Chong Pei ◽

Li Xie ◽

Nianan He

Keyword(s):

Risk Stratification ◽

Diagnostic Accuracy ◽

Thyroid Nodules ◽

Needle Aspiration ◽

Fine Needle ◽

Measurement Function ◽

Conventional Ultrasound ◽

Single Method ◽

Benign Thyroid Nodules ◽

Benign Thyroid

Objective: We evaluated the diagnostic accuracy of perinodular stiffness, four risk stratification systems (RSSs) (KWAK-TIRADS, ACR-TIRADS, EU-TIRADS, and C-TIRADS), and the combination of perinodular stiffness and these four RSSs in differentiating malignant from benign thyroid nodules (TNs). Methods: A total of 788 TNs in 726 patients were examined with conventional ultrasound (US) examination and sound touch elastography (STE). All TNs were classified by each of the four RSSs. The stiffness inside (E) the TNs was measured by STE. The stiffness of the 2.0mm perinodular region (Eshell) was measured with the Shell measurement function of STE. The diagnostic performances of four RSSs, the E values, and the Eshell values were evaluated. All TNs were further divided into subgroups based on size (≤ 10 mm group and > 10 mm group). Results: Ninety-six TNs were classified as benign and 692 as malignant. Among the single-method approaches, ACR-TIRADS showed the highest AUC (0.77) for differentiating malignant from benign TNs for all TNs included. Eshell showed the highest AUC (0.75) in differentiating malignant from benign TNs for TNs with sizes ≤ 10 mm, and there were no significant differences in AUC among all single methods for diagnosis of TNs with sizes > 10 mm (P > 0.05). The combination of C-TIRADS and Eshell/E yielded the highest AUC for all TNs (0.83) and for TNs with size ≤ 10 mm (0.85) compared with other combinations. Conclusions: Eshell/E combined with conventional US improves the diagnostic accuracy in TNs, and may reduce unnecessary fine needle aspiration.

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