Comparison of Different Ultrasound Classification Systems of Thyroid Nodules for Identifying Malignant Potential: A Cross-sectional Study

Chen, Hua; Ye, Jun; Song, Junhui; You, Yong; Liu, Yanna

doi:10.6061/clinics/2021/e2126

Cited by 4 publications

(3 citation statements)

References 20 publications

(51 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The risk stratification systems for thyroid nodules (ACR- TIRADS and others) are often affected by a low diagnostic specificity. Recent studies noted the same limitations in applying those guidelines as in the present study ( 7 , 10 , 27 – 32 ). Significant differences were noted between MTC and PTC features: hyper- or isoechoic nodules more often described in MTC and lobulated margins in PTC.…”

Section: Discussionmentioning

confidence: 51%

Diagnostic efficiency of existing guidelines and the AI-SONIC™ artificial intelligence for ultrasound-based risk assessment of thyroid nodules

et al. 2023

View full text Add to dashboard Cite

IntroductionThe thyroid ultrasound guidelines include the American College of Radiology Thyroid Imaging Reporting and Data System, Chinese-Thyroid Imaging Reporting and Data System, Korean Society of Thyroid Radiology, European-Thyroid Imaging Reporting and Data System, American Thyroid Association, and American Association of Clinical Endocrinologists/American College of Endocrinology/Associazione Medici Endocrinologi guidelines. This study aimed to compare the efficiency of the six ultrasound guidelines vs. an artificial intelligence system (AI-SONICTM) in differentiating thyroid nodules, especially medullary thyroid carcinoma.MethodsThis retrospective study included patients with medullary thyroid carcinoma, papillary thyroid carcinoma, or benign nodules who underwent nodule resection between May 2010 and April 2020 at one hospital. The diagnostic efficacy of the seven diagnostic tools was evaluated using the receiver operator characteristic curves.ResultsFinally, 432 patients with 450 nodules were included for analysis. The American Association of Clinical Endocrinologists/American College of Endocrinology/Associazione Medici Endocrinologi guidelines had the best sensitivity (88.1%) and negative predictive value (78.6%) for differentiating papillary thyroid carcinoma or medullary thyroid carcinoma vs. benign nodules, while the Korean Society of Thyroid Radiology guidelines had the best specificity (85.6%) and positive predictive value (89.6%), and the American Thyroid Association guidelines had the best accuracy (83.7%). When assessing medullary thyroid carcinoma, the American Thyroid Association guidelines had the highest area under the curve (0.78), the American College of Radiology Thyroid Imaging Reporting and Data System guidelines had the best sensitivity (90.2%), and negative predictive value (91.8%), and AI-SONICTM had the best specificity (85.6%) and positive predictive value (67.5%). The Chinese-Thyroid Imaging Reporting and Data System guidelines had the best under the curve (0.86) in diagnosing malignant tumors vs. benign tumors, followed by the American Thyroid Association and Korean Society of Thyroid Radiology guidelines. The best positive likelihood ratios were achieved by the Korean Society of Thyroid Radiology guidelines and AI-SONICTM (both 5.37). The best negative likelihood ratio was achieved by the American Association of Clinical Endocrinologists/American College of Endocrinology/Associazione Medici Endocrinologi guidelines (0.17). The highest diagnostic odds ratio was achieved by the American Thyroid Association guidelines (24.78).DiscussionAll six guidelines and the AI-SONICTM system had satisfactory value in differentiating benign vs. malignant thyroid nodules.

show abstract

Section: Discussionmentioning

confidence: 51%

Diagnostic efficiency of existing guidelines and the AI-SONIC™ artificial intelligence for ultrasound-based risk assessment of thyroid nodules

et al. 2023

View full text Add to dashboard Cite

show abstract

“…Each guideline recommends a sonographic classification of thyroid nodules in an attempt to distinguish the malignant nodules before cytological evaluation or before follow-up. The ACR-TIRADS guideline compared to ATA and AACE/ACE/AME guidelines is widely accepted, with decreasing the number of FNA and has the highest accuracy in recognition of suspicious nodules [5,29]. In 2017 The American College of Radiology, on the basis of breast reporting system, has introduced the Thyroid Imaging, Reporting and Data System (TI-RADS) that describe the ultrasound features of thyroid nodules such as composition, echogenicity, shape, margin, presence of echogenic foci and aid in calculation for a predictive score from TR1 -benign to TR5 -highly suspicious (Table 1) [5].…”

Section: Paraclinical Assessment and Managementmentioning

confidence: 99%

The current assessment and management of thyroid nodules

Cojocaru¹,

Alin²

2023

MJHS

View full text Add to dashboard Cite

Introduction. The widespread use of diagnostic imaging favored the increasing incidence of thyroid nodules. Although most of nodules are benign, their clinical importance lies in the need to exclude malignancy. In assessing and managing thyroid nodules may occur the phenomenon of overdiagnosis and overtreatment on one hand and the risk of missing an aggressive thyroid cancer on the other hand. The equilibrium that has to be reached by health care providers. Materials and methods. We conducted a PubMed, MEDLINE, ISI Web of Science, Cochrane databases search for the relevant and recent guidelines, meta-analysis, randomized controlled trial, reviews articles related to „thyroid nodules assessment”, „thyroid nodules management”, „thyroid nodules guidelines”, „thyroid nodules surgery”. Results. The initial assessment of thyroid nodules includes an evaluation of clinical, laboratory and sonographic risk factors. Due to the sonographic features and size, the nodules are selected for biopsy. Cytologically benign nodules are usually followedup, minimally invasive techniques may be required in certain cases. In suspected or confirmed malignancy, the treatment options of thyroid nodules include surgery or active surveillance. The main controversies appear in management of nodules with inconclusive cytology, low-risk cancers, multinodular goiters, hyperfunctioning nodules, and thyroid incidentalomas. Conclusions. Thyroid nodules due to the high incidence and heterogeneity of background diseases cannot be evaluated and managed in one standardized approach. In the existing literature, there are discussed multiple options for diagnosis and treatment of thyroid nodules. We have reviewed the guidelines recommendations, novel published data, and controversial questions for health care professionals, to understand and provide efficient, personalized, and cost-effective management of patients with thyroid nodules in order to avoid automatic intensive testing and intervention and balancing each case from the patient expectations and demands.

show abstract

“…Therefore, to simplify the nodule diagnosis, current thyroid guidelines (Thyroid Imaging Reporting And Data System (TIRADS)) advocate the use of ultrasonography (USG) as a preliminary test for all patients suspected of having thyroid nodule. 2,3 Clinical variables and ultrasound (US) findings as per the TIRADS guidelines are recommended as a primary criterion to assess the benign and malignant nature of a nodule. Based on these results, the clinician further advises an additional confirmatory testing (FNAB) or simple routine US follow-up.…”

Section: Introductionmentioning

confidence: 99%

Thyroid nodule ultrasound accuracy in predicting thyroid malignancy based on TIRADS system

Nie¹,

Zhu²,

Yan³

et al. 2022

Adv Clin Exp Med

View full text Add to dashboard Cite

Background. A frequent prevalence of thyroid nodules in patients prioritizes the need for an accurate method that characterizes them as benign or malignant. Fine-needle aspiration biopsy (FNAB) and thyroid ultrasonography (USG) are currently used for this purpose. However, since FNAB is complicated, time-consuming and expensive, thyroid USG, a fast and highly sensitive method, is preferably used. Although USG is reported as a suitable method for characterization of thyroid nodules, there are some contrasting studies available which report its limited use in the differentiation of benign and malignant thyroid nodules.Objectives. This meta-analysis aims to assess the accuracy of ultrasound in predicting thyroid cancer in terms of sensitivity, specificity and diagnostic odds ratios (ORs) for positive and negative results. Materials and methods.Systematic and extensive literature search on the use of ultrasound (US) to predict thyroid cancer was conducted in the databases of Scopus, CINAHL (via EBSCO), MEDLINE (via PubMed), and Web of Science, covering the period from 2010 till 2021. The morphological features of thyroid nodules observed during the USG were analyzed based on Thyroid Imaging Reporting And Data System (TIRADS) guidelines. The accuracy of thyroid US was determined using parameters such as sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), and diagnostic ORs. Moreover, the respective forest plot and hierarchical summary receiver operating characteristics (HSROC) curve were plotted.Results. A total of 2765 reference studies were examined, and among them, 15 relevant references were selected. The selected studies were heterogeneous and included retrospective and prospective studies. The risk of publication bias is low as the p-value for both Egger's and Begg's tests is >0.05. The overall sensitivity of 92.53% (95% confidence interval (95% CI): [84.55%; 96.33%]), specificity of 33.88% (95% CI: [23. 16%; 45.53%]) and diagnostic OR of 12.36 (95% CI: [3.90%; 54. 11%]) are achieved. These results were statistically significant with a p-value < 0.001 and are predictive of US accuracy in detecting cancer.Conclusions. The present meta-analysis, on the basis of statistically significant results, demonstrated the high accuracy of thyroid ultrasound in detection of malignant nature of nodules in patients suspected with a worrisome thyroid nodule.

show abstract

Comparison of Different Ultrasound Classification Systems of Thyroid Nodules for Identifying Malignant Potential: A Cross-sectional Study

Cited by 4 publications

References 20 publications

Diagnostic efficiency of existing guidelines and the AI-SONIC™ artificial intelligence for ultrasound-based risk assessment of thyroid nodules

Diagnostic efficiency of existing guidelines and the AI-SONIC™ artificial intelligence for ultrasound-based risk assessment of thyroid nodules

The current assessment and management of thyroid nodules

Thyroid nodule ultrasound accuracy in predicting thyroid malignancy based on TIRADS system

Contact Info

Product

Resources

About