Thyroid Ultrasound Reporting Lexicon: White Paper of the ACR Thyroid Imaging, Reporting and Data System (TIRADS) Committee

Grant, Edward G.; Tessler, Franklin N.; Hoang, Jenny K.; Langer, Jill E.; Beland, Michael D.; Berland, Lincoln L.; Cronan, John J.; Desser, Terry S.; Frates, Mary C.; Hamper, Ulrike M.; Middleton, William D.; Reading, Carl C.; Scoutt, Leslie M.; Stavros, A. Thomas; Teefey, Sharlene A.

doi:10.1016/j.jacr.2015.07.011

Cited by 383 publications

(313 citation statements)

References 36 publications

(60 reference statements)

Supporting

Mentioning

287

Contrasting

Unclassified

Order By: Relevance

“…The first step of the committee was to create the Thyroid Ultrasound Reporting Lexicon to describe ultrasound characteristics of thyroid nodules, providing concise written definitions and illustrations to guide practitioners (22). Also recently, the Korean Society of Thyroid Radiology proposed a modification to the TI-RADS system (K-TIRADS) using a flowchart-guided classification according to the presence or absence of different ultrasound features found in thyroid nodules (6).…”

Section: Introductionmentioning

confidence: 99%

Likelihood of malignancy in thyroid nodules according to a proposed Thyroid Imaging Reporting and Data System (TI-RADS) classification merging suspicious and benign ultrasound features

Delfim

Veiga

Vidal

et al. 2017

Arch. Endocrinol. Metab.

View full text Add to dashboard Cite

Objective: The aim of this study was to describe the ultrasound features of benign and malignant thyroid nodules and evaluate the likelihood of malignancy associated with each feature according to the Bethesda System for Reporting Thyroid Cytopathology and histopathology. With this analysis, we propose a new TI-RADS classification system. Materials and methods: The likelihood of malignancy from ultrasound features were assessed in 1413 thyroid nodules according to the Bethesda System for Reporting Thyroid Cytopathology and histopathological findings. A score was established by attributing different weights to each ultrasound feature evaluated. Results: Features positively associated with malignancy in bivariate analysis received a score weight of +1. We attributed a weight of +2 to features which were independently associated with malignancy in a multivariate analysis and +3 for those associated with the highest odds ratio for malignancy (> 10.0). Hence, hypoechogenicity (graded as mild, moderate or marked, according to a comparison with the overlying strap muscle), microcalcification and irregular/microlobulated margin received the highest weights in our scoring system. Features that were negatively associated with malignancy received weights of -2 or -1. In the proposed system a cutoff score of 2 (sensitivity 97.4% and specificity 51.6%) was adopted as a transition between probably benign (TI-RADS 3) and TI-RADS 4a nodules. Overall, the frequency of malignancy in thyroid nodules according to the categories was 1.0% for TI-RADS 3, 7.8% for TI-RADS 4a, 35.3% for TI-RADS 4b, and 84.7% for TI-RADS 5. Conclusion: A newly proposed TI-RADS classification adequately assessed the likelihood of malignancy in thyroid nodules. Arch Endocrinol Metab. 2017;61(3):211-21.

show abstract

Section: Introductionmentioning

confidence: 99%

Likelihood of malignancy in thyroid nodules according to a proposed Thyroid Imaging Reporting and Data System (TI-RADS) classification merging suspicious and benign ultrasound features

Delfim

Veiga

Vidal

et al. 2017

Arch. Endocrinol. Metab.

View full text Add to dashboard Cite

show abstract

“…11 The Thyroid Imaging and Reporting System (TI-RADS) was developed to provide a minimum common data set for standardized risk stratification of thyroid nodules. 7,[12][13][14][15] For a thyroid ultrasound report to conform to TI-RADS it must include the following nodule characteristics: marked hypoechogenicity, taller-than-wide shape, microcalcifications, irregular margins and solid component in addition to size. 2,[15][16][17] First used by Horvath and colleagues, 14 the TI-RADS system is analogous to the standardization of breast imaging by which categories defining risk of malignancy are used as part of the synoptic reporting scheme for assessments.…”

mentioning

confidence: 99%

“…The European Thyroid Association (ETA), American Thyroid Association (ATA) and the American Association of Endocrinologists (AACE) endorse the use of ultrasonography to stratify nodules into low, intermediate, and high risk of malignancy. 13 The reality facing many physicians is that the reporting of thyroid ultrasounds originates from multiple sites and is dictated by physicians of varying experience, practice volumes and styles of documentation. 9,[18][19][20] There is very little research on the content of the actual ultrasound reports that radiologists provide to physicians.…”

mentioning

confidence: 99%

The utility of thyroid ultrasonography in the management of thyroid nodules

Gamme

Parrington

Wiebe

et al. 2017

CJS

View full text Add to dashboard Cite

Background: Ultrasonography for thyroid nodules is one of the most common imaging tests performed in the general population. Details from ultrasound reports guide biopsies and surgery. This study quantifies the completeness of these reports based on Thyroid Imaging and Reporting System (TI-RADS) criteria and considers their utility in predicting malignant disease. Methods:We retrospectively reviewed ultrasound reports for 329 thyroidectomy patients and extracted data elements using the TI-RADS criteria: nodule size, echogenicity, margins, vascularity, solid/cystic composition and the presence or absence of microcalcifications and the halo sign. We assessed the reports to determine whether individual or multiple criteria were associated with malignancy.Results: More than 97% of reports document nodule size; however, more than 90% of the reports noted only 3 or fewer of the 6 remaining TI-RADS criteria. The presence of microcalcifications was the most sensitive marker of malignancy (> 90%), whereas the documentation of irregular margins was the most specific indicator of malignancy (88%). Overall it was clear that microcalcifications, hypoechogenicity, irregular margins and solid nodules were significantly more likely to be found in malignant neoplasms; their absence predicted benign disease. Because so few reports consistently documented all criteria, the overall ability of thyroid ultrasonography to discriminate between lowerand higher-risk nodules is limited. Conclusion:Although the accuracy of thyroid ultrasonography is good, few ultrasound reports contain the necessary information, as defined by TI-RADS, to predict malignancy and guide management. When reported, microcalcifications and/or irregular margins are the best predictors of malignancy.Contexte : L'échographie des nodules thyroïdiens est l'une des épreuves d'imagerie les plus souvent effectuées dans la population générale. Les détails fournis par l'échographie guident les biopsies et la chirurgie. Cette étude quantifie l'exhaustivité des rapports d'échographie selon les critères TI-RADS (Thyroid Imaging and Reporting System) et en mesure l'utilité pour prédire les cancers.Méthodes : Nous avons passé en revue de façon rétrospective les rapports d'échographie de 329 patients ayant subi une thyroïdectomie et nous en avons extrait les éléments sous l'angle des critères TI-RADS : taille des nodules, échogénicité, marges, vascularité, composition solide c. kystique, présence ou absence de microcalcifications et signe du halo. Nous avons évalué les rapports afin de déterminer si certains critères individuels ou multiples pouvaient être associés au cancer.Résultats : Plus de 97 % des rapports mentionnent la taille des nodules; mais, plus de 90 % des rapports ne font état que de 3 critères ou moins sur les 6 autres critères TI-RADS. La présence de microcalcifications a été le marqueur tumoral le plus sensible (> 90 %), tandis que la présence de marges irrégulières a été le marqueur tumoral le plus spécifique (88 %). Dans l'ensemble, les microcalcifications, l'...

show abstract

“…3. Identify the nodule at risk to be malignant by risk stratification based on identification of high risk factors [12]. 4.…”

Section: Thyroid Gland Thyroid Nodulesmentioning

confidence: 99%

Thyroid Ultrasound: State of the Art Part 1 – Thyroid Ultrasound reporting and Diffuse Thyroid Diseases

et al. 2017

View full text Add to dashboard Cite

Accurate differentiation of focal thyroid nodules (FTL) and thyroid abnormalities is pivotal for proper diagnostic and therapeutic work-up. In these two part articles, the role of ultrasound techniques in the characterization of FTL and evaluation of diffuse thyroid diseases is described to expand on the recently published World Federation in Ultrasound and Medicine (WFUMB) thyroid elastography guidelines and review how this guideline fits into a complete thyroid ultrasound exam.

show abstract

Thyroid Ultrasound Reporting Lexicon: White Paper of the ACR Thyroid Imaging, Reporting and Data System (TIRADS) Committee

Cited by 383 publications

References 36 publications

Likelihood of malignancy in thyroid nodules according to a proposed Thyroid Imaging Reporting and Data System (TI-RADS) classification merging suspicious and benign ultrasound features

Likelihood of malignancy in thyroid nodules according to a proposed Thyroid Imaging Reporting and Data System (TI-RADS) classification merging suspicious and benign ultrasound features

The utility of thyroid ultrasonography in the management of thyroid nodules

Thyroid Ultrasound: State of the Art Part 1 – Thyroid Ultrasound reporting and Diffuse Thyroid Diseases

Contact Info

Product

Resources

About