Comparison among TIRADS (ACR TI-RADS and KWAK- TI-RADS) and 2015 ATA Guidelines in the diagnostic efficiency of thyroid nodules

Gao, Luying; Xi, Xuehua; Jiang, Yuxin; Yang, Xiao; Wang, Ying; Zhu, Shenling; Lai, Xingjian; Zhang, Xiaoyan; Zhao, Ruina; Zhang, Bo

doi:10.1007/s12020-019-01843-x

Cited by 104 publications

(108 citation statements)

References 19 publications

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“…The ATA classification showed a sensitivity of 86% and a specificity of 86.9%. For the ATA classification, a number of studies reported a sensitivity of 77.3–98.2% and a specificity of 37.4–76.6% ( 32 , 33 , 34 , 35 ), consistent with the results of this study, whereas FNA results showed a sensitivity of 68.5% and a specificity of 91.4%. The low sensitivity indicated a high rate of misdiagnosis.…”

Section: Discussionsupporting

confidence: 90%

The combination of ATA classification and FNA results can improve the diagnostic efficiency of malignant thyroid nodules

Wang

Zhu

et al. 2020

Endocrine Connections

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Purpose: To determine the diagnostic efficiency of the ATA classification and ultrasound-guided fine-needle aspiration (FNA) results in identifying the risk factors of malignancy, we analyzed the thyroid nodules of patients who underwent thyroidectomy and compared preoperative ATA classifications with FNA results. Methods: We retrospectively analyzed 274 nodules of 196 patients who underwent ultrasonography, FNA and thyroidectomy. Histopathological findings of thyroid nodules were considered as the gold standard in the analysis of the diagnostic efficiency of the ATA classification and FNA results. Univariate analysis and binary multivariate logistic regression analysis were applied to identify the ultrasound features associated with malignancy. Results: The overall malignancy rate of 274 nodules was 41.6%. The areas under the ROC curves (AUCs) for the ATA classification and FNA results were 0.88 and 0.878, respectively (P<0.001). The sensitivity and specificity of the ATA classification were 86% and 86.9%, whereas those of FNA results were 68.5% and 91.4%, respectively. The specificity (98.7%) and sensitivity (94.3%) increased after the combined use of the ATA classification and FNA results. Taller-than-wide shape, microcalcifications, hypoechogenicity and irregular margins were independent risk factors for malignancy. Microcalcifications had the highest OR (7.58), and taller-than-wide shape had the highest specificity in BSRTC I, II, III and IV cytologies. Conclusion: The diagnostic efficiency of the ATA classification and FNA results in identifying malignant nodules was high, and the use of both criteria improved the diagnostic accuracy. Taller-than-wide shape, microcalcifications, hypoechogenicity and irregular margins were independent risk factors for malignancy.

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Section: Discussionsupporting

confidence: 90%

The combination of ATA classification and FNA results can improve the diagnostic efficiency of malignant thyroid nodules

Wang

Zhu

et al. 2020

Endocrine Connections

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“…A similar study was performed by Gao et al to compare the TI-RADS system proposed by Kwak (Kwak-TIRADS) with ATA and ACR TI-RADS systems in 2,544 nodules that were also surgically excised and had an even higher overall malignancy rate of 66.1% compared with ours. They, too, found significantly higher observed rates of malignancy for the intermediate ATA risk stratum and the higher ACR TI-RADS risk strata in comparison with expected malignancy thresholds [25]. Two possible explanations for this discrepancy are as follows.…”

Section: Discussionmentioning

confidence: 92%

“…Although there have been a few studies that have compared different risk stratification systems [21][22][23][24], and in particular, the ATA and ACR-TIRADS systems [25,26], to our knowledge, this is the first study to evaluate the performance of these two systems using raters from multiple clinical disciplines. We found that both ATA and ACR TI-RADS risk stratifications systems exhibited similar diagnostic performance and interobserver agreement, although ATA guidelines were more accurate in predicting the malignancy risk for each risk stratum in our study population.…”

Section: Discussionmentioning

confidence: 99%

A Multidisciplinary Head-to-Head Comparison of American College of Radiology Thyroid Imaging and Reporting Data System and American Thyroid Association Ultrasound Risk Stratification Systems

et al. 2019

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Background. Ultrasound plays a critical role in evaluating thyroid nodules. We compared the performance of the two most popular ultrasound malignancy risk stratification systems, the 2015 American Thyroid Association (ATA) guidelines and the American College of Radiology Thyroid Imaging and Reporting Data System (ACR TI-RADS). Materials and Methods. We retrospectively identified 250 thyroid nodules that were surgically removed from 137 patients. Their ultrasound images were independently rated using both ATA and ACR TI-RADS by six raters with expertise in ultrasound interpretation. For each system, we generated a receiver operating characteristic curve and calculated the area under the curve (AUC). Results. Sixty-five (26%) nodules were malignant. There was "fair agreement" among raters for both ATA and ACR TI-RADS. Our observed malignancy risks for ATA and ACR TI-RADS categories were similar to expected risk thresholds with a few notable exceptions including the intermediate ATA risk category and the three highest risk categories for ACR TI-RADS. Biopsy of 226 of the 250 nodules would be indicated by ATA guidelines based on nodule size and mean ATA rating. One hundred fortysix nodules would be biopsied based on ACR TI-RADS. The sensitivity, specificity, and negative and positive predictive values were 92%, 10%, 79%, and 27%, respectively, for ATA and 74%, 47%, 84%, and 33%, respectively, for ACR TI-RADS. The AUC for ATA was 0.734 and for ACR TI-RADS was 0.718. Conclusion. Although both systems demonstrated good diagnostic performance, ATA guidelines resulted in a greater number of thyroid biopsies and exhibited more consistent malignancy risk prediction for higher risk categories. The Oncologist 2020;25:398-403 Implications for Practice: With the rising incidence of thyroid nodules, the need for accurate detection of malignancy is important to avoid the overtreatment of benign nodules. Ultrasonography is one of the key tools for the evaluation of thyroid nodules, although the use of many different ultrasound risk stratification systems is a hindrance to clinical collaboration in everyday practice and the comparison of data in research. The first step toward the development of a universal thyroid nodule ultrasound malignancy risk stratification system is to better understand the strengths and weaknesses of the current systems in use.

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“…1). [32], [36], [37] TI-RADS nach Sánchez [29] Punktesumme + Binnenperfusion + suspekte Lymphknoten T1, T2: 0 % T3: 0 % (< 5 %) T4a: 9,5 % (5-10 %) T4b: 48 % (10-50 %) T4c: 85 % (50-85 %) T5:~100 % (> 85 %)…”

Section: Strukturiert Befunden: Ti-rads Und Andere Klassifikationssysunclassified

“…Originalkohorte mit 3650 Knoten [29] TI-RADS nach Park [27] Muster + Punktesumme [32], [33], [34], [35], [37], [39], [40] AACE / ACE / AME 2016 [30] Muster-basiert [48]. Eine glatte oder lediglich unscharfe Begrenzung zwischen solidem und zystischem Anteil weist auf Benignität hin, eine mikrolobulierte Begrenzung auf Malignität, v. a. in Kombination mit Mikrokalzifikationen des soliden Anteils [49], [50].…”

Section: Alleunclassified

TI-RADS und andere sonografische Klassifikationssysteme für Schilddrüsenknoten

2020

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Mehrere Arbeitsgruppen und Fachgesellschaften haben in den letzten Jahren Klassifikationssysteme für die sonografische Dignitätsbeurteilung von Schilddrüsenknoten vorgeschlagen, häufig unter dem Überbegriff „TI-RADS“. Diese Systeme zielen auf eine vereinheitlichte und möglichst umfassende Beurteilung von Knoten anhand definierter sonographischer Kriterien ab. Für verschiedene Befundkonstellationen leitet sich so eine jeweilige Malignomwahrscheinlichkeit ab, und die Rate an unnötigen Feinnadelpunktionen kann nachweislich reduziert werden. Es soll zudem verhindert werden, dass wichtige Einzelaspekte der Malignitätsabschätzung im Befund nicht adressiert werden. Der Beitrag stellt eine Übersicht der relevanten Klassifikationssysteme dar, erläutert die Definitionen der einzelnen sonographischen Kriterien unterstützt durch Bildbeispiele und fasst die aktuelle Evidenz zu den genannten Systemen zusammen.

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Comparison among TIRADS (ACR TI-RADS and KWAK- TI-RADS) and 2015 ATA Guidelines in the diagnostic efficiency of thyroid nodules

Cited by 104 publications

References 19 publications

The combination of ATA classification and FNA results can improve the diagnostic efficiency of malignant thyroid nodules

The combination of ATA classification and FNA results can improve the diagnostic efficiency of malignant thyroid nodules

A Multidisciplinary Head-to-Head Comparison of American College of Radiology Thyroid Imaging and Reporting Data System and American Thyroid Association Ultrasound Risk Stratification Systems

TI-RADS und andere sonografische Klassifikationssysteme für Schilddrüsenknoten

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