Similarities and Differences Between Thyroid Imaging Reporting and Data Systems

Yoon, So Jin; Na, Dong Gyu; Gwon, Hye Yun; Paik, Wooyul; Kim, Won Jun; Song, Jae Seok; Shim, Myoung Sook

doi:10.2214/ajr.18.20510

Cited by 53 publications

(47 citation statements)

References 22 publications

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“…The US lexicon plays an important role in the risk stratification of thyroid nodules for malignancy. Isolated macrocalcifications are categorized as intermediate suspicious nodules in the K-TIRADS [7,8] and as moderately suspicious nodules in the ACR TI-RADS [8][9][10]. However, it is not specified in the risk stratification of thyroid nodules in other thyroid society guidelines.…”

Section: Discussionmentioning

confidence: 99%

“…An isolated macrocalcification is defined as a calcified nodule with complete posterior acoustic shadowing in which no soft tissue component can be identified due to dense shadowing on US [6]. A US lexicon for isolated macrocalcifications has not been established, and the presence of isolated macrocalcifications has only been considered as part of the risk stratification of nodules in the Korean Thyroid Imaging Reporting and Data System (K-TIRADS) [7,8] and in the American College of Radiology (ACR) Thyroid Imaging Reporting and Data System (TI-RADS) [8][9][10]. Previous studies [11][12][13][14] classified isolated macrocalcifications as a type of rim or peripheral calcification.…”

Section: Introductionmentioning

confidence: 99%

“…Previous studies [11][12][13][14] classified isolated macrocalcifications as a type of rim or peripheral calcification. However, the details of an isolated macrocalcification cannot be evaluated using US alone due to the dense posterior shadowing, which causes challenges in incorporating nodules with isolated macrocalcifications into the risk stratification of thyroid nodules [7][8][9][10].…”

Section: Introductionmentioning

confidence: 99%

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CT features of thyroid nodules with isolated macrocalcifications detected by ultrasonography

Paik

Gwon

et al. 2020

Ultrasonography

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Purpose: A thyroid nodule with an isolated macrocalcification is visualized as a calcified nodule with complete posterior shadowing on ultrasonography (US). This study aimed to determine the computed tomography (CT) features of isolated macrocalcifications detected using US. Methods: This study included 20 patients who had thyroid nodules with isolated macroalcifications and underwent neck CT or chest CT. The patients were enrolled from a sample of 82 patients with isolated macrocalcifications detected by US drawn from 7,142 consecutive patients who underwent thyroid biopsy at two institutions. We evaluated the CT features of nodules with isolated macrocalcifications and categorized them as central or rim calcifications. We assessed the nodule size and the frequency of nondiagnostic fine-needle aspiration (FNA) results and malignant tumors according to the CT features of isolated macrocalcifications. Results: CT scans showed central calcifications in 18 (90.0%) and rim calcifications in two (10.0%) of the 20 nodules with isolated macrocalcifications. Among the 18 nodules with central isolated macrocalcifications, complete compact calcification was found in six nodules and partial coarse calcification in 12 nodules. In 18 nodules with central isolated macrocalcifications, the nondiagnostic FNA rate and frequency of malignant tumors were not significantly different between complete and partial central calcifications (P=0.620 and P=0.999, respectively). Malignant tumors were only found in nodules with central isolated macrocalcifications. Conclusion: The majority of nodules with isolated macrocalcifications showed central calcifications on CT. Thyroid nodules with isolated macrocalcifications detected by US should not be classified as having a type of rim or peripheral calcification.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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CT features of thyroid nodules with isolated macrocalcifications detected by ultrasonography

Paik

Gwon

et al. 2020

Ultrasonography

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“…An isolated macrocalcification is categorized as a nodule with an intermediate suspicion in the Korean Thyroid Imaging Reporting and Data System (TIRADS) (11,12) and a moderate suspicion in the American College of Radiology TIRADS (12)(13)(14). However, it is not specified in the American Thyroid Association (ATA) guideline and the European TIRADS (15,16).…”

Section: Us Examination and Image Analysismentioning

confidence: 99%

“…The malignancy risk of an isolated macrocalcification on US has not been established, and there has been little investigation on the behavior of malignant tumors that manifest as isolated macrocalcifications. Furthermore, the management of nodules with isolated macrocalcifications is controversial (12,14).…”

Section: Us Examination and Image Analysismentioning

confidence: 99%

Thyroid Nodules with Isolated Macrocalcifications: Malignancy Risk of Isolated Macrocalcifications and Postoperative Risk Stratification of Malignant Tumors Manifesting as Isolated Macrocalcifications

Gwon

Noh

et al. 2020

Korean J Radiol

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Objective: To determine the malignancy risk of isolated macrocalcifications (a calcified nodule with complete posterior acoustic shadowing) detected on ultrasonography (US) and to evaluate the postoperative American Thyroid Association (ATA) risk stratification of malignant tumors manifesting as isolated macrocalcifications. Materials and Methods: A total of 3852 thyroid nodules (≥ 1 cm) of 3061 consecutive patients who had undergone biopsy between January 2011 and June 2018 were included in this study. We assessed the prevalence, malignancy rate, and size distribution of isolated macrocalcifications and evaluated the histopathologic features and postoperative ATA risk stratification of malignant tumors manifesting as isolated macrocalcifications. Results: Isolated macrocalcifications were found in 38 (1.2%) of the 3061 patients. Final diagnosis was established in 30 (78.9%) nodules; seven malignant tumors were diagnosed as papillary thyroid carcinomas (PTCs). The malignancy rate of the isolated macrocalcifications was 23.3% in the 30 nodules with final diagnoses and 18.4% in all nodules. Among the six surgically-treated malignant tumors, five (83.3%) had an extrathyroidal extension (ETE) (minor ETE 1, gross ETE 4), and two (33.3%) had macroscopic lymph node metastasis. Four (66.7%) malignant tumors were categorized as high-risk tumors, one as an intermediate-risk tumor, and one as a low-risk tumor using the ATA risk stratification. Histopathologically, out of the six malignant tumors, ossifications were noted in four (66.7%) and predominant calcifications in two (33.3%). Conclusion: The US pattern of isolated macrocalcifications (≥ 1 cm) showed an intermediate malignancy risk (at least 18.4%). All malignant tumors were PTCs, and most showed an aggressive behavior and a high or intermediate postoperative ATA risk.

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Diagnostic performance of the EU TI‐RADS and ACR TI‐RADS scoring systems in predicting thyroid malignancy

Chatti

Oueslati

Azaiez

et al. 2023

Endocrino Diabet & Metabol

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Introduction: Several ultrasound scoring systems have been developed to stratify the risk of malignancy of thyroid nodules, including ACR (American College of Radiology) and EU (European) TI-RADS. This study aimed to assess the diagnostic performance of these two classifications using histology as a reference standard. Methods:It was a single-centre, retrospective study including 156 patients who underwent thyroidectomy. Ultrasound data of 198 nodules (99 malignant nodules and 99 benign nodules) were analysed. Both classifications were applied for all nodules.Results: Ultrasound criteria associated with malignancy were solid composition (OR=7.81; p < 10 −3 ), hypoechoic character (OR=16.42; p < 10 −3 ), irregular contours (OR=7.47; p < 10 −3 ), taller-than-wide shape (OR=3.58; p = 0.02), microcalcifications (OR=3.02; p = .006) and the presence of cervical adenopathy (OR=3.89; p = .006). The prevalence of malignancy was 15.5%, 69% and 76.9% for EU TI-RADS categories 3, 4 and 5, respectively. It was 33.3%, 57% and 91.1% for ACR TI-RADS categories 3, 4 and 5, respectively. For category 5, EU TI-RADS and ACR TI-RADS had sensitivities of 60% and 41%, specificities of 82% and 96%, respectively. For categories 4 and 5 combined, the diagnostic performance of these two classification systems became comparable with a sensitivity of 89% and 86% for EU-TIRADS and ACR-TIRADS, respectively. The area under the ROC curve was 0.81 for the EU TI-RADS classification and 0.82 for the ACR TI-RADS classification.

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Similarities and Differences Between Thyroid Imaging Reporting and Data Systems

Cited by 53 publications

References 22 publications

CT features of thyroid nodules with isolated macrocalcifications detected by ultrasonography

CT features of thyroid nodules with isolated macrocalcifications detected by ultrasonography

Thyroid Nodules with Isolated Macrocalcifications: Malignancy Risk of Isolated Macrocalcifications and Postoperative Risk Stratification of Malignant Tumors Manifesting as Isolated Macrocalcifications

Diagnostic performance of the EU TI‐RADS and ACR TI‐RADS scoring systems in predicting thyroid malignancy

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