Ultrasound imaging classifications of thyroid nodules for malignancy risk stratification and clinical management: state of the art

Abstract

Assessing the risk of malignancy in the thyroid with ultrasound (US) is crucial in patients with nodules, as it can aid in selecting those who should have a fine-needle aspiration (FNA) biopsy performed. Many studies have examined whether the US characteristics of thyroid nodules are useful indicators of histological malignancy. Overall, these investigations have identified a few US features that are significantly more frequent in malignant thyroid nodules which can be coalesced into a defining set to be used as an indicator of a higher risk of malignancy. Despite these efforts, none of these classifications have been widely adopted worldwide, and there are still conflicting recommendations from different institutions. Understanding the role and appropriate utilization of these systems could facilitate the effective interpretation and communication of thyroid US findings among referring physicians and radiologists. In this comprehensive review, we outline the major US classification systems of thyroid nodules published in the last few years.

False-Positive Malignant Diagnosis of Nodule Mimicking Lesions by Computer-Aided Thyroid Nodule Analysis in Clinical Ultrasonography Practice

“…It is important to note that there are certain differences among the different TIRADS systems (such as ACR and EU TIRADS) compared to the presently applied K-TIRADS; for a comparison of these systems, see the review by Chiara et al [59].…”

US‐based risk stratification “guidelines” for thyroid nodules: Quō Vādis?

“…Then this author performed a scoping review of the peer‐reviewed literature in electronic databases (e‐databases) to rapidly identify articles comparing two or more UGMTNs and/or non‐UGMTNs . E‐databases included Medline (PubMed), EBSCO, Google, and Google Scholar published from 2010 to 2019 to capture articles comparing UGMTNs or non‐UGMTNs . The keyword combinations of thyroid, nodule, ultrasound, risk, comparison, guideline, malignancy, and classification returned 28 peer‐reviewed articles comparing two or more UGMTNs.…”

“…Their subanalysis of TR3 and TR4 grades revealed that the ACR TI‐RADS‐17 recommendations for discriminating nodules with high‐risk cytology might miss a small percentage of cancers. A third 2019 study by Floridi et al reviewed and compared the ACR TI‐RADS‐2017, EU TI‐RADS, South Korean TI‐RADS, AACE/ACE/AME classification, ATA‐2015, and BTA UGMTNs . Although all UGMTNs achieved high sensitivities and specificities, the authors could not establish a “best” system due to their study limitations.…”

Patología molecular del cáncer de tiroides. Revisión de algunos aspectos

“…Severino Rey Nodar 1 , Ignacio Torrero De Pedro 2 1 Departamento de Anatomía Patológica Hospital Manises, Valencia, España. 2 Alumno de Escuela de Medicina de la Universidad CEU Cardenal Herrera Valencia.…”