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

Qi, Qi; Aiyun, Zhou; Guo, Shu; Huang, Xingzhi; Chen, Songli; Li, Yaohui; Xu, Pan

doi:10.3389/fendo.2021.763897

Cited by 39 publications

(36 citation statements)

References 31 publications

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“…In the present study, data from patients with thyroid nodules in a northeastern province of China were collected and graded according to C-TIRADS, and the sensitivity, specificity, and accuracy of C-TIRADS in identifying benign and malignant thyroid nodules were found to be 88.14%, 74.56%, and 85.50%, respectively. The diagnostic performance AUC was 0.813, which was similar to Qi’s results ( 14 ) and lower than Qiao et al.’s results ( 15 ). This might have been related to the proportion of micronodules and geographical factors.…”

Section: Discussionsupporting

confidence: 80%

“…However, these studies demonstrated a high diagnostic performance of C-TIRADS in differentiating benign and malignant thyroid nodules. Zhu ( 16 ) and Qi ( 14 ) compared the diagnostic performance of C-TIRADS with other guidelines and showed that the AUC of C-TIRADS is higher than that of the other TIRADS guidelines, indicating that it has better diagnostic performance and might reduce the rate of unnecessary FNA.…”

Section: Discussionmentioning

confidence: 99%

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Diagnostic performance of C-TIRADS combined with SWE for the diagnosis of thyroid nodules

Gao

Peng

et al. 2022

Front. Endocrinol.

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ObjectiveTo explore the value of the optimal parameters of shear wave elastography (SWE) to enhance the identification of benign and malignant thyroid nodules by C-TIRADS.MethodsThe two-dimensional ultrasonography images and SWE images of 515 patients with a total of 586 thyroid nodules were retrospectively analyzed. The nodules were divided into the D ≤10 mm and D >10 mm groups according to size and were graded by C-TIRADS. With the pathological results as the gold standard, the receiver operating characteristic (ROC) curves were drawn, and the area under the curve (AUC) was calculated to compare the diagnostic performances of C-TIRADS, SWE, and the combination of the two on the benign and malignant thyroid nodules.ResultsThe ROC showed that the AUC of the maximum elastic modulus (0.875) was higher than that of the mean elastic modulus (0.798) and elasticity ratio (0.772), with an optimal cutoff point of 51 kPa, which was the optimal parameter to distinguish the malignant from the benign nodules (P < 0.001). In the D ≤10 mm group, the AUC of TIRADS combined with SWE (0.955) was elevated by 0.172 compared with the application of C-TIRADS alone (0.783), and the difference was statistically significant (P < 0.05). In the D >10 mm group, the AUC of TIRADS combined with SWE (0.904) was elevated by 0.076 compared with the application of C-TIRADS alone (0.828), and the difference was statistically significant (P < 0.05). Among all nodules, the application of C-TIRADS alone had a sensitivity of 88.14%, a specificity of 74.56%, and an accuracy of 85.50% in diagnosing benign and malignant thyroid nodules, while the sensitivity, specificity, and accuracy were 93.22%, 90.35%, and 92.66%, respectively, in combination with SWE.ConclusionThe diagnostic performance of SWE in combination with TIRADS was better than that of SWE or C-TIRADS alone. Here, SWE enhanced the diagnostic performance of C-TIRADS for the benign and malignant thyroid nodules, most significantly for nodules with D ≤10 mm.

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Section: Discussionsupporting

confidence: 80%

Section: Discussionmentioning

confidence: 99%

Diagnostic performance of C-TIRADS combined with SWE for the diagnosis of thyroid nodules

Gao

Peng

et al. 2022

Front. Endocrinol.

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“…On the other hand, the results of Qi et al. ( 13 ), which analyzed 3,524 nodules, showed that C-TIRADS had only a little advantage over the ACR TIRADS and the K-TIRADS, and a significant advantage over the EU-TIRADS. This may be due to sample size limitations and bias caused by the fact that not all patients meeting the criteria were included in the study.…”

Section: Discussionmentioning

confidence: 96%

“…C-TIRADS takes into account both the international standards for the US evaluation and the local conditions of the national health organization in China. Presently, C-TIRADS have been used in some studies to classify thyroid nodules (12)(13)(14), but the systematic performance of C-TIRADS has been so far marginally explored.…”

Section: Introductionmentioning

confidence: 99%

Diagnostic performance of C-TIRADS in malignancy risk stratification of thyroid nodules: A systematic review and meta-analysis

Zhan

2022

Front. Endocrinol.

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BackgroundChinese thyroid imaging reports and data systems (C-TIRADS) is a novel malignancy risk stratification used for thyroid nodule diagnosis and guiding thyroid fine needle aspiration (FNA). In this review, we aim to assess the performance of C-TIRADS in malignancy risk stratification of thyroid nodules.MethodsPubMed, Medline, Web of Science, Embase, CNKI, and Wanfang databases were searched until 1 April 2022. Original articles reporting data about C-TIRADS and setting FNA or histology as reference standards were included. C-TIRADS 4A, 4B, and 4C were set as thresholds, respectively, to obtain pooled sensitivity, specificity, positive likelihood ratio (LR+), negative likelihood ratio (LR-), diagnostic odds ratio (DOR), and the area under the curve (AUC). Integrated nested Laplace approximation was used for Bayesian bivariate meta-analysis of diagnostic tests.ResultsSixteen studies were included, evaluating 11,506 thyroid nodules. The rate of malignancy in each risk classification is comparable with that in C-TIRADS. C-TIRADS 4B appeared to have better diagnostic performance than C-TIRADS 4A and 4C. The pooled sensitivity, specificity, LR+, LR-, and DOR of C-TI-RADS 4B were 0.94 (95% CI: 0.89–0.97), 0.70 (95% CI: 0.60–0.79), 3.20 (95% CI: 2.28–4.39), 0.09 (95% CI: 0.05–0.15), and 33.71 (95% CI: 25.51–42.40), respectively. The area under the summary ROC curve was 0.94 (95% CI: 0.90-0.96).ConclusionC-TIRADS performed well in malignancy risk stratification of thyroid nodules. C-TIRADS 4B showed strong evidence of detecting malignancy.

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“…Thirdly, the interobserver agreement was not evaluated in this study. However, recent studies showed that interobserver reproducibility for thyroid nodule US reporting and US classi cation systems in ACR TIRADS and other RSSs appears fairly adequate [24][25][26][27] . In contrast, an uni ed lexicon of thyroid US features, a simpli ed method of classi cation, and a dedicated training in the description of thyroid US ndings may increase the observers' agreement 25 .…”

Section: Discussionmentioning

confidence: 99%

The feasibility of reducing the thresholds for biopsy in ACR TIRADS and AI TIRADS

Cui

et al. 2022

Preprint

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At present, there is still controversy over whether to perform fine needle aspiration (FNA) on sub-centimeter thyroid nodules with high suspicion of malignancy. Our aim was to estimate the feasibility of reducing the original thresholds for biopsy in American College of Radiology Thyroid Imaging Reporting and Data System (ACR TIRADS) and Artificial Intelligence TIRADS (AI TIRADS). A total of 3201 thyroid nodules with definitive histology obtained were included. Ultrasound categories were assigned according to each TIRADS. We lowered the original FNA thresholds of TR3-TR5 in ACR and AI TIRADS and estimated whether the decreased FNA thresholds could be accepted and used to modified ACR and AI TIRADS. Then, we estimated and compared the diagnostic performance between modified TIRADS and original TRADS to determine if the decreased thresholds could be an effective strategy. 1474 (46.0%) thyroid nodules were diagnosed as malignant after thyroidectomy. Modified ACR TIRADS had higher sensitivity and lower specificity, unnecessary biopsy rate, missed malignancy rate compared with original ACR TIRADS (all P< 0.05). Similar trends were seen in modified AI TIRADS versus original AI TIRADS (all P < 0.05). In conclusion, biopsy of all nodules with TR5 in both ACR TIRADS and AI TIRADS might be an effective strategy, regardless of the nodules dimension. This paper contributes to the contradictory concerning whether perform FNA for the nodules smaller than 10 mm.

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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

Cited by 39 publications

References 31 publications

Diagnostic performance of C-TIRADS combined with SWE for the diagnosis of thyroid nodules

Diagnostic performance of C-TIRADS combined with SWE for the diagnosis of thyroid nodules

Diagnostic performance of C-TIRADS in malignancy risk stratification of thyroid nodules: A systematic review and meta-analysis

The feasibility of reducing the thresholds for biopsy in ACR TIRADS and AI TIRADS

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