scholarly journals S-Detect Software vs. EU-TIRADS Classification: A Dual-Center Validation of Diagnostic Performance in Differentiation of Thyroid Nodules

2020 ◽  
Vol 9 (8) ◽  
pp. 2495
Author(s):  
Ewelina Szczepanek-Parulska ◽  
Kosma Wolinski ◽  
Katarzyna Dobruch-Sobczak ◽  
Patrycja Antosik ◽  
Anna Ostalowska ◽  
...  
Keyword(s):  
Risk Stratification ◽  
Predictive Value ◽  
Mixed Models ◽  
Diagnostic Performance ◽  
Image Interpretation ◽  
Ultrasound Image ◽  
High Sensitivity ◽  
Data System ◽  
P Value ◽  
Thyroid Imaging

Computer-aided diagnosis (CAD) and other risk stratification systems may improve ultrasound image interpretation. This prospective study aimed to compare the diagnostic performance of CAD and the European Thyroid Imaging Reporting and Data System (EU-TIRADS) classification applied by physicians with S-Detect 2 software CAD based on Korean Thyroid Imaging Reporting and Data System (K-TIRADS) and combinations of both methods (MODELs 1 to 5). In all, 133 nodules from 88 patients referred to thyroidectomy with available histopathology or with unambiguous results of cytology were included. The S-Detect system, EU-TIRADS, and mixed MODELs 1–5 for the diagnosis of thyroid cancer showed a sensitivity of 89.4%, 90.9%, 84.9%, 95.5%, 93.9%, 78.9% and 93.9%; a specificity of 80.6%, 61.2%, 88.1%, 53.7%, 73.1%, 89.6% and 80.6%; a positive predictive value of 81.9%, 69.8%, 87.5%, 67%, 77.5%, 88.1% and 82.7%; a negative predictive value of 88.5%, 87.2%, 85.5%, 92.3%, 92.5%, 81.1% and 93.1%; and an accuracy of 85%, 75.9%, 86.5%, 74.4%, 83.5%, 84.2%, and 87.2%, respectively. Comparison showed superiority of the similar MODELs 1 and 5 over other mixed models as well as EU-TIRADS and S-Detect used alone (p-value < 0.05). S-Detect software is characterized with high sensitivity and good specificity, whereas EU-TIRADS has high sensitivity, but rather low specificity. The best diagnostic performance in malignant thyroid nodule (TN) risk stratification was obtained for the combined model of S-Detect (“possibly malignant” nodule) and simultaneously obtaining 4 or 5 points (MODEL 1) or exactly 5 points (MODEL 5) on the EU-TIRADS scale.

scholarly journals 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)

2020 ◽  
Vol 9 (1) ◽  
pp. 236 ◽  
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.

scholarly journals 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

2020 ◽  
Vol 2020 ◽  
pp. 1-11 ◽  
Author(s):  
Shufang Pei ◽  
Bin Zhang ◽  
Shuzhen Cong ◽  
Juanjuan Liu ◽  
Suqing Wu ◽  
...  
Keyword(s):  
Risk Stratification ◽  
Real Time ◽  
Diagnostic Performance ◽  
Thyroid Nodules ◽  
Data System ◽  
Maximum Diameter ◽  
Thyroid Imaging ◽  
Benign Thyroid Nodules ◽  
Benign Thyroid ◽  
Tissue Elastography

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.

scholarly journals Thyroid Imaging Reporting and Data System (TI-RADS): the impact of Quantitative Strain Elastography for better stratification of cancer risks.

2015 ◽  
Vol 17 (3) ◽  
pp. 327 ◽  
Author(s):  
Dana Stoian ◽  
Bogdan Timar ◽  
Mihnea Derban ◽  
Stelian Pantea ◽  
Florian Varcus ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Risk Stratification ◽  
Predictive Value ◽  
Thyroid Nodules ◽  
Data System ◽  
Strain Elastography ◽  
Thyroid Imaging ◽  
Risk Stratification Model ◽  
Area Under Roc Curve ◽  
The Impact

Aims: Due to the elevated prevalence of the solid thyroid nodules in a general population, an appropriate selection of cases referred to surgery is of paramount importance. The main aim of our study was to evaluate the performance of the Thyroid Imaging Reporting and Data System (TI-RADS) as a differential diagnosis tool for thyroid nodules. Material and methods: We evaluated 174 nodules using TI-RADS risk stratification model, using conventional ultrasound and real time elastography parameters and linear multifrequency probe (Hitachi Preirus Machine, Hitachi Inc., Japan). All the nodules were classified using the TI-RADS system according to echogenicity, margins, shapes, calcification, lymph nodes, and increased strain ra- tion. The results were compared with the pathology exam, which was considered the golden standard diagnosis. Results: The prevalence of malignant nodules was 16.7% (29 cases). The differential diagnosis performance regarding the malignant tumor for TI-RADS is appropriate for clinical use, obtaining an area under ROC curve of 0.95761 [0.8424-0.989] 95% confidence interval. Combining TI-RADS 2, 3 and 4A as probably benign and TI-RADS 4B and 5 as probably malignant, the sensitiv- ity, specificity, positive predictive value, and negative predictive value were 97.93%, 86.20%, 97.26% and 89.28% respec- tively. The overall accuracy of the method was 95.97%.According to the American Association of Clinical Endocrinologists Guidelines, 169 cases required FNAB examination; by applying the TI-RADS scoring system, the necessity for FNAB would decrease to 74 cases. Conclusion: Quantitative strain elastography, as the 6th parameter of TI-RADS system, adds diagnostic power to the risk stratification model.

scholarly journals Combine preoperative estimation of serum thyroglobulin and ACR-thyroid imaging reporting and data system scoring could accurately define malignant thyroid nodules

2020 ◽  
Vol 8 (1) ◽  
pp. 32
Author(s):  
Waseem A. Shoda
Keyword(s):  
Roc Curve ◽  
Predictive Value ◽  
Thyroid Nodules ◽  
Curve Analysis ◽  
Data System ◽  
Operating Characteristics ◽  
Roc Curve Analysis ◽  
Serum Thyroglobulin ◽  
Thyroid Imaging ◽  
Significant Difference

Background: Evaluation of diagnostic ability of preoperative estimation of serum thyroglobulin (TG) to detect malignant thyroid nodules (TN) in comparison to the American College of Radiology, Thyroid imaging reporting and data system (ACR-TIRADS), fine needle aspiration cytology (FNAC) and intraoperative frozen section (IO-FS).Methods: 34 patients with ACR-TIRADS 2-4 TN were evaluated preoperatively for identification of malignancy and all underwent total thyroidectomy with bilateral neck block dissection if indicated. Results of preoperative investigations were statistically analyzed using the Receiver operating characteristics (ROC) curve analysis as predictors for malignancy in comparison to postoperative paraffin sections.Results: Preoperative serum TG levels had 100% sensitivity and negative predictive value, while ACR-TIRADS scoring had 100% specificity and positive predictive value with accuracy rates of 95.35% and 97.67% for TG and TIRADS, respectively. ROC curve analysis defined preoperative ACR-TIRADS class and serum TG as highly diagnostic than FNAC for defining malignancy with non-significant difference between areas under curve for TIRADS and TG. For cases had intermediate risk of malignancy on TIRADS, IO-FS had missed 3, FNAC missed 4, while serum TG levels were very high in the 13 cases and were defined by ROC curve as the only significant predictor for malignancy.Conclusions: Preoperative estimation of serum TG showed higher diagnostic validity than FNAC, high predictability of cancer and ability to verify the intermediate findings on TIRADS. Combined preoperative TIRADS and TG estimation could accurately discriminate malignant TN with high accuracy and spare the need for preoperative FNAC or IO-FS. 

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