Fine needle aspiration biopsy of thyroid nodule smaller than 1.0 cm: accuracy of TIRADS classification system in more than 1000 nodules

Mendes, Guilherme Falleiros; Garcia, M. R. Calero; Falsarella, Priscila Mina; Rahal, Antônio; Cavalcante, Francisco; Garcia, Rodrigo Gobbo

doi:10.1259/bjr.20170642

Cited by 29 publications

(17 citation statements)

References 25 publications

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“…This means that the diagnostic value of the EU‐TIRADS is maintained in subcentimeter nodules. This is concordant with the study by Mendes et al, in which the proportion of malignancies among nodules with TIRADS 2 is 0.91% and for TIRADS 3 is 2.87%. Among those classified as 4A, 12.26%; with 4B classification, 34.43%; with 4C classification, 66.6%; and among those with 5 classifications, 85.7%.…”

Section: Discussionsupporting

confidence: 93%

A multicentre validation study for the EU‐TIRADS using histological diagnosis as a gold standard

Trimboli

Ngu

Royer³

et al. 2019

Clinical Endocrinology

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Objective Many systems for risk stratification of thyroid nodule with ultrasound (US) have been proposed and the EU‐TIRADS issued by the ETA in 2017 was the last to have been published. The present study was undertaken to evaluate whether the malignancy risk of each category corresponded to the given range of the guidelines and assess the diagnostic value of EU‐TIRADS in a multi‐institutional trial with histology as gold standard. Design Three institutions in Switzerland, France and United Kingdom shared this retrospective study. Enrolment period was 2013‐2017. Included were patients who had undergone surgery with a detailed preoperative thyroid US. Methods Cancer risk was calculated for each EU‐TIRADS score. Predictivity tests were estimated. Nonparametric statistical analysis was used. Results The final series included 1058 nodules of which 257 (24.3%) carcinomas. Nodules were classified as EU‐TIRADS 2, 3, 4 and 5 in 6.7, 46.4, 26.2 and 20.7%, respectively. Cancer prevalence was 1.4, 3.5, 17 and 87.7% in classes 2‐5, respectively (P < 0.0001). EU‐TIRADS 5 had a significantly higher cancer rate than the other summed categories (7.7%; P < 0.0001) with OR 84.7. When EU‐TIRADS 4 and 5 were combined, 93% sensitivity and 97% NPV were found and findings of the three institutions were quite similar. Using the recommended criteria for FNA negative predictive value was 90.9%. Conclusions The cancer rate was within or close to the given range described in the EU‐TIRADS guidelines. The diagnostic value was satisfactory. The results were similar in the three institutions participating in the study.

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Section: Discussionsupporting

confidence: 93%

A multicentre validation study for the EU‐TIRADS using histological diagnosis as a gold standard

Trimboli

Ngu

Royer³

et al. 2019

Clinical Endocrinology

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“…The risk of cancer was reported to be 6-17% in patients with a TI-RADS score of 4 [8]. In one study, they found malignancy rate of 12.6-66.6% in TI-RADS 4 [19]. In our study, 19.4% (n = 26) of the cases were TI-RADS 4.…”

Section: Discussionsupporting

confidence: 45%

Use of the TI-RADS scoring system in the evaluation of thyroid nodules

Gökosmanoğlu¹

2019

Ann Clin Anal Med

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Aim: Thyroid ultrasonography-guided fine needle aspiration is known to be a cost-effective, safe diagnostic method for evaluating thyroid nodules but it is an invasive procedure. Various sonographic criteria have been proposed to estimate the risk of malignancy in thyroid nodules. TI-RADS (Thyroid Image Reporting and Data System) is one of these scoring systems. In this study, it was aimed to investigate the reliability and applicability of the TI-RADS system in our operated patients with definite TI-RADS results. Material and Method: A total of 134 patients who underwent surgery for nodular or multinodular goiter diagnosis between September 2005 and June 2018 in the Medical Park Hospital and Fatsa State Hospital endocrinology clinic and general surgery clinic were included in the study. Demographic characteristics, preoperative thyroid ultrasonographic findings and postoperative pathology results were collected retrospectively. Results: In our study, we found the rate of thyroid cancer as 0% in cases with TI-RADS score 2-3, the rate of cancer as 61.5% (12 papillary thyroid cancer and 4 follicular thyroid cancer in total 16 thyroid cancer n: 16) in cases with TI-RADS score 4 and the rate of cancer 88.2% (papillary thyroid cancer n: 24, medullary thyroid cancer n: 2, follicular thyroid cancer n: 2, indeterminate thyroid cancer n: 2) in cases with TI-RADS score 5. Discussion: Many studies have shown that this thyroid ultrasonography function is not only a risk classification, but also an effective treatment for patients. In our study, we clearly demonstrated that the use of the TI-RADS scoring system in thyroid nodules assessed by experienced individuals prevented the need for unnecessary fine needle aspiration. These findings show that TI-RADS classification provides reliable results in well-categorized thyroid nodules.

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“…Studies have shown that undifferentiated cancers that lead to a high mortality rate account for 1% to 2% of malignant nodules. [2,3] The majority of malignant nodules (especially those that are <1 cm) often have indolent behavior with positive prognoses. [4] Surgical resection is the primary treatment for thyroid nodules, but post-operative complications (eg, hypoparathyroidism, recurrent laryngeal nerve paralysis, etc) have adverse effects on patient quality of life.…”

Section: Introductionmentioning

confidence: 99%

Update on thyroid ultrasound

Liang

Cai

et al. 2019

Chinese Medical Journal

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Objective Ultrasound imaging is well known to play an important role in the detection of thyroid disease, but the management of thyroid ultrasound remains inconsistent. Both standardized diagnostic criteria and new ultrasound technologies are essential for improving the accuracy of thyroid ultrasound. This study reviewed the global guidelines of thyroid ultrasound and analyzed their common characteristics for basic clinical screening. Advances in the application of a combination of thyroid ultrasound and artificial intelligence (AI) were also presented. Data sources An extensive search of the PubMed database was undertaken, focusing on research published after 2001 with keywords including thyroid ultrasound, guideline, AI, segmentation, image classification, and deep learning. Study selection Several types of articles, including original studies and literature reviews, were identified and reviewed to summarize the importance of standardization and new technology in thyroid ultrasound diagnosis. Results Ultrasound has become an important diagnostic technique in thyroid nodules. Both standardized diagnostic criteria and new ultrasound technologies are essential for improving the accuracy of thyroid ultrasound. In the standardization, since there are no global consensus exists, common characteristics such as a multi-feature diagnosis, the performance of lymph nodes, explicit indications of fine needle aspiration, and the diagnosis of special populations should be focused on. Besides, evidence suggests that AI technique has a good effect on the unavoidable limitations of traditional ultrasound, and the combination of diagnostic criteria and AI may lead to a great promotion in thyroid diagnosis. Conclusion Standardization and development of novel techniques are key factors to improving thyroid ultrasound, and both should be considered in normal clinical use.

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Fine needle aspiration biopsy of thyroid nodule smaller than 1.0 cm: accuracy of TIRADS classification system in more than 1000 nodules

Cited by 29 publications

References 25 publications

A multicentre validation study for the EU‐TIRADS using histological diagnosis as a gold standard

A multicentre validation study for the EU‐TIRADS using histological diagnosis as a gold standard

Use of the TI-RADS scoring system in the evaluation of thyroid nodules

Update on thyroid ultrasound

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