Abstract
Objective
To compare the diagnostic efficacy of the Chinese Thyroid Imaging Reporting and Data Systems (C-TIRADS) with the well-accepted ACR-TIRADS guidelines in identifying benign from malignant thyroid nodules.
Methods
A total of 2064 nodules were collected from 1627 patients undergoing thyroid ultrasonography in our center between October 2019 and November 2021. Nodules were divided into two groups: “≥1 cm” and “<1 cm”. Ultrasound features of each nodule were observed and recorded by two physicians with more than 15 years of experience and classified according to the ACR-TIRADS and C-TIRADS guidelines, respectively.
Results
The area under the curve of the ACR-TIRADS guideline was higher than that of the C-TIRADS guideline (0.922, P = 0.017), the specificity and positive predictive value of the C-TIRADS guideline were higher (81.64%, 88.72%, all P < 0.05), which was more significant in the subgroup of nodules <1 cm (P = 0.001). In addition, there was no statistical difference between the two guidelines in the diagnostic efficacy indicators for nodules ≥1 cm. The ACR-TIRADS effectively reduced unnecessary biopsies compared with the C-TIRADS (P < 0.05).
Conclusions
There was high agreement between the two guidelines for the diagnosis of thyroid nodules, C-TIRADS guidelines had a higher specificity and simplicity while were inferior to the ACR-TIRADS guidelines in terms of reducing the number of biopsies.
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References
L. Xu, F. Zeng, Y. Wang, Y. Bai, X. Shan, L. Kong, Prevalence and associated metabolic factors for thyroid nodules: a cross-sectional study in Southwest of China with more than 120 thousand populations. BMC Endocr. Disord. 21(1), 175 (2021)
B. Song, Z. Zuo, J. Tan, J. Guo, W. Teng, Y. Lu, C. Liu, Association of thyroid nodules with adiposity: a community-based cross-sectional study in China. BMC Endocr. Disord. 18(1), 3 (2018)
M. Li, R. Zheng, L. Dal Maso, S. Zhang, W. Wei, S. Vaccarella, Mapping overdiagnosis of thyroid cancer in China. Lancet Diabetes Endocrinol. 9(6), 330–332 (2021)
S. Guth, U. Theune, J. Aberle, A. Galach, C.M. Bamberger, Very high prevalence of thyroid nodules detected by high frequency (13 MHz) ultrasound examination. Eur. J. Clin. Invest. 39(8), 699–706 (2009)
S.H. Choi, E.-K. Kim, J.Y. Kwak, M.J. Kim, E.J. Son, Interobserver and intraobserver variations in ultrasound assessment of thyroid nodules. Thyroid 20, 167–172 (2010)
T.L. Henrichsen, C.C. Reading, Thyroid ultrasonography. Part 2: nodules. Radio. Clin. North Am. 49, 417–424 (2011)
W.J. Moon, J.H. Baek, S.L. Jung et al. Ultrasonography and the ultrasound-based management of thyroid nodules. Korean J. Radio. 12, 1–14 (2011)
F.N. Tessler, W.D. Middleton, E.G. Grant, J.K. Hoang, L.L. Berland, S.A. Teefey, J.J. Cronan, M.D. Beland, T.S. Desser, M.C. Frates, L.W. Hammers, U.M. Hamper, J.E. Langer, C.C. Reading, L.M. Scoutt, A.T. Stavros, ACR Thyroid Imaging, Reporting and Data System (TI-RADS): White Paper of the ACR TI-RADS Committee. J. Am. Coll. Radio. 14(5), 587–595 (2017)
W.D. Middleton, S.A. Teefey, C.C. Reading et al. Multiinstitutional analysis of thyroid nodule risk stratification using the American College of Radiology Thyroid Imaging Reporting and Data System. AJR Am. J. Roentgenol. 208(6), 1331–1341 (2017)
B.R. Haugen, E.K. Alexander, K.C. Bible et al. 2015 American Thyroid Association Management Guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer. Thyroid 26(1), 1–133 (2016)
Superficial Organs and Vasculature Group of Ultrasound Medicine Branch of Chinese Medical Association, Chinese Thyroid and Breast Ultrasound Artificial Intelligence Consortium. 2020 Chinese guidelines for ultrasound malignancy risk stratification of thyroid nodules: C-TIRADS. Chin J Ultrasound Imaging 30(3), 185–200 (2021)
Q.F. Chen, S.Z. Wu, Comparative study on the diagnostic efficacy of C-TIRADS and ACR-TIRADS for stratifying the risk of malignancy in thyroid nodules. Chin. J. Ultrasound Imaging 30(10), 861–867 (2021)
S. Mao, L.P. Zhao, X.H. Li, Y.F. Sun, H. Su, Y. Zhang, K.L. Li, D.C. Fan, M.Y. Zhang, Z.G. Sun, S.C. Wang, The diagnostic performance of 2020 Chinese Ultrasound Thyroid Imaging Reporting and Data System in thyroid nodules. Zhonghua Yi Xue Za Zhi 101(45), 3748–3753 (2021)
J.D. Iannuccilli, J.J. Cronan, J.M. Monchik, Risk for malignancy of thyroid nodules as assessed by sonographic criteria: the need for biopsy. J. Ultrasound Med. 23(11), 1455–1464 (2004)
E. Koike, S. Noguchi, H. Yamashita et al. Ultrasonographic characteristics of thyroid nodules: prediction of malignancy. Arch. Surg. 136(3), 334–337 (2001)
B.K. Chan, T.S. Desser, I.R. McDougall, R.J. Weigel, R.B. Jeffrey Jr., Common and uncommon sonographic features of papillary thyroid carcinoma. J. Ultrasound Med. 22(10), 1083–1090 (2003)
G.H. Klinck, T. Winship, Psammoma bodies and thyroid cancer. Cancer 12(4), 656–662 (1959)
M.L. Khoo, J.L. Freeman, I.J. Witterick et al. Underexpression of p27/Kip in thyroid papillary microcarcinomas with gross metastatic disease. Arch. Otolaryngol. Head. Neck Surg. 128(3), 253–257 (2002)
L.B. Ferreira, E. Gimba, J. Vinagre, M. Sobrinho-Simões, P. Soares, Molecular aspects of thyroid calcification. Int J. Mol. Sci. 21(20), 7718 (2020)
L. Yin, W. Zhang, W. Bai, W. He, Relationship between morphologic characteristics of ultrasonic calcification in thyroid nodules and thyroid carcinoma. Ultrasound Med. Biol. 46(1), 20–25 (2020)
P. Jun, L.C. Chow, R.B. Jeffrey, The sonographic features of papillary thyroid carcinomas: pictorial essay. Ultrasound Q. 21, 39–45 (2005)
D.Y. Yoon, J.W. Lee, S.K. Chang, C.S. Choi, E.J. Yun, Y.L. Seo, K.H. Kim, H.S. Hwang, Peripheral calcification in thyroid nodules: ultrasonographic features and prediction of malignancy. J. Ultrasound Med. 26(10), 1349–1355 (2007)
J.R. Wienke, W.K. Chong, J.R. Fielding et al. Sonographic features of benign thyroid nodules: interobserver reliability and overlap with malignancy. J. Ultrasound Med. 22, 1027–1031 (2003)
S. Sorrenti, V. Dolcetti, M. Radzina et al. Artificial intelligence for thyroid nodule characterization: where are we standing? Cancers (Basel) 14(14), 3357 (2022)
Q. Qi, A. Zhou, S. Guo, X. Huang, S. Chen, Y. Li, P. Xu, Explore the diagnostic efficiency of Chinese Thyroid Imaging Reporting and Data Systems by comparing with the other four systems (ACR TI-RADS, Kwak-TIRADS, KSThR-TIRADS, and EU-TIRADS): a single-center study. Front Endocrinol. (Lausanne) 12, 763897 (2021)
H. Zhu, Y. Yang, S. Wu, K. Chen, H. Luo, J. Huang, Diagnostic performance of US-based FNAB criteria of the 2020 Chinese guideline for malignant thyroid nodules: comparison with the 2017 American College of Radiology guideline, the 2015 American Thyroid Association guideline, and the 2016 Korean. Quant. Imaging Med. Surg. 11(8), 3604–3618 (2021)
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Cai, M., Chen, L., Shui, L. et al. Explore the diagnostic performance of 2020 Chinese Thyroid Imaging Reporting and Data Systems by comparing with the 2017 ACR-TIRADS guidelines: a single-center study. Endocrine 80, 399–407 (2023). https://doi.org/10.1007/s12020-023-03304-y
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DOI: https://doi.org/10.1007/s12020-023-03304-y