Is TIRADS a practical and accurate system for use in daily clinical practice?

Chandramohan, Anuradha; Khurana, Abhishek; Thippeswamy, Pushpa Bhari; Manipadam, Marie Therese; Naik, Dukhabandhu; Nicolaï, Thomas; Abraham, Deepak Thomas; Paul, Mazhuvanchary Jacob

doi:10.4103/0971-3026.178367

Cited by 43 publications

(31 citation statements)

References 17 publications

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“…Previous studies have demonstrated that TIRADS classification systems have good interobserver variability . However, some suggest that intermediate categories have poor interobserver variabilities compared to categories at the extremes of the spectrum . To the best of the authors’ knowledge, this study represents the first investigation in the literature evaluating interobserver variability among TIRADS classification in patients with cytologically indeterminate, Afirma suspicious thyroid nodules.…”

Section: Discussionmentioning

confidence: 89%

“…The aim of TIRADS was to decrease variation in the reporting of thyroid nodules and thereby improve patient management and cost‐effectiveness by minimizing the number of unnecessary FNAs. Previous studies have demonstrated that TIRADS classification systems have good interobserver variability . However, some suggest that intermediate categories have poor interobserver variabilities compared to categories at the extremes of the spectrum .…”

Section: Discussionmentioning

confidence: 99%

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TIRADS Interobserver Variability Among Indeterminate Thyroid Nodules: A Single‐Institution Study

Sahli

Sharma²,

Canner³

et al. 2018

J of Ultrasound Medicine

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Objectives-A high proportion of cytologically indeterminate, Afirma Gene Expression Classifier "suspicious" thyroid nodules are benign. The Thyroid Imaging Reporting and Data System (TIRADS), was proposed by the American College of Radiology in 2017 to help classify thyroid nodules based on ultrasound characteristics in a standardized fashion to guide management. We aim to determine the interobserver variability of TIRADS classification among cytologically indeterminate and Afirma suspicious nodules.Methods-We retrospectively queried cytopathology archives for thyroid fineneedle aspiration specimens obtained between February 2012 and September 2016 with associated (1) indeterminate diagnosis, (2) ultrasound imaging at our institution, (3) Afirma suspicious result, and (4) surgery at our institution. We compared the TIRADS variability of the 3 blinded radiologists using intraclass correlation coefficients.Results-Our cohort consisted of 127 nodules. Intraclass correlation coefficients can be interpreted as follows: less than 0.4, poor; 0.4 to 0.59, fair; 0.6 to 0.74, good; 0.75 to 1.00, excellent. The intraclass correlation coefficients of the raw TIRADS score and category variability was 0.561 (95% confidence interval [CI]: 0.464-0.651) or fair and 0.547 (95% CI, 0.449-0.640) or fair, respectively. When analyzing composition, echogenicity, shape, margin, and echogenic foci, the ICCs were 0.552 (95% CI, 0.454-0.643), fair; 0.533 (95% CI, 0.432-0.627), fair; 0.359 (95% CI, 0.248-0.469), poor; 0.192 (95% CI, 0.084-0.308), poor; and 0.549 (95% CI, 0.451-0.641), fair, respectively.Conclusions-Our results show that among the subset of cytologically indeterminate and Afirma suspicious nodules, TIRADS interobserver variability was fair. Shape and margin criteria were the biggest sources of disagreement. Large prospective studies are needed to evaluate the interobserver variability of TIRADS in this subset of thyroid nodules.

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Section: Discussionmentioning

confidence: 89%

Section: Discussionmentioning

confidence: 99%

TIRADS Interobserver Variability Among Indeterminate Thyroid Nodules: A Single‐Institution Study

Sahli

Sharma²,

Canner³

et al. 2018

J of Ultrasound Medicine

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“…TIRADS is a simple, accurate, everyday applicable reporting system that provides stratification of thyroid nodules according to malignancy risk based on the number of suspicious US features. 7,29,30 It supplies categorization of a thyroid nodule according to the predicted malignancy risk. 7,8 Until now, various versions of TIRADS systems have been suggested for thyroid nodules.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic accuracy of Thyroid Imaging Reporting and Data System in the prediction of malignancy in nodules with atypia and follicular lesion of undetermined significance cytologies

Başer¹,

Çakır

Topaloğlu

et al. 2016

Clinical Endocrinology

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“…Researchers have recently attempted to validate this type of approach as an instrument for use in clinical practice, with some authors proposing different TI-RADS versions in selected populations (14)(15)(16)(17)(18)(19)(20).…”

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.

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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.

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Is TIRADS a practical and accurate system for use in daily clinical practice?

Cited by 43 publications

References 17 publications

TIRADS Interobserver Variability Among Indeterminate Thyroid Nodules: A Single‐Institution Study

TIRADS Interobserver Variability Among Indeterminate Thyroid Nodules: A Single‐Institution Study

Diagnostic accuracy of Thyroid Imaging Reporting and Data System in the prediction of malignancy in nodules with atypia and follicular lesion of undetermined significance cytologies

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

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