Predictive Value of Malignancy of Thyroid Nodule Ultrasound Classification Systems: A Prospective Study

Abstract

Classification systems had elevated predictive value of malignancy in high-risk classes. ATA and AACE/ACE/AME systems were effective for ruling out indication to FNA in low-US-risk nodules. A similar diagnostic accuracy and a substantial interobserver agreement was provided by the three- and the five-category classifications.

A multicentre validation study for the EU‐TIRADS using histological diagnosis as a gold standard

“…In a report by Ha et al, 2000 nodules were evaluated and American Thyroid Association (ATA) recommendations, American College of Radiology‐TIRADS (ACR) and Korean TIRADS (K‐TIRADS) had malignancy risks close to the EU‐TIRADS in high suspicion and intermediate category (ie 76.6%‐79.3% and 23%‐25.2%, respectively). However, the overall calculated malignancy rate of EU‐TIRADS 5 (high risk) was 87.7% (lowest rate was 84.6% among three institutions), which is slightly higher than the high end of the suggested cancer risk range (26%‐87%), and higher than the reported cancer rates of high‐risk nodules of AACE/ACE/AME guidelines with very similar US criteria to EU‐TIRADS and high suspicion nodules of ATA and KSThR guidelines . We believe there could be at least three different reasons for this: all centres implied in the project were high volumes one and as it has been shown by Na et al, higher specificity for the diagnostic of malignancy is seen than in low centre volume.…”

“…rates of high-risk nodules of AACE/ACE/AME guidelines with very similar US criteria to EU-TIRADS and high suspicion nodules of ATA and KSThR guidelines. 13,14 We believe there could be at least three different reasons for this: all centres implied in the project were high volumes one and as it has been shown by Na et al, 15 higher specificity for the diagnostic of malignancy is seen than in low centre volume. Second, there could be a recruitment bias due to the surgical population studied with a higher proportion of malignant cases than in cytological series.…”

Minimally-invasive treatments for benign thyroid nodules: a Delphi-based consensus statement from the Italian minimally-invasive treatments of the thyroid (MITT) group

“…In this setting, the EU-TIRADS system has been proven to be a valuable tool. Thyroid nodules classified as EU-TIRADS 3 have been proven to have a low risk of malignancy, which ranges between 2% and 4% [36,37]. In nodules that demonstrate both cytological and US low-risk features, the risk of a false negative result at cytology is definitely low, probably ranging from 1% to 3%.…”

TI-RADS und andere sonografische Klassifikationssysteme für Schilddrüsenknoten

“…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].…”