Le système TIRADS en échographie thyroïdienne

Russ, Gilles; Bigorgne, Claude; Royer, Bénédicte Brounais-Le; Rouxel, A.; Bienvenu-Perrard, M.

doi:10.1016/j.jradio.2011.03.022

Cited by 110 publications

(56 citation statements)

References 17 publications

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“…The presence of some US features had earlier been described as highly suspicious for malignancy, and they include marked hypoechogenicity, taller-than-wide shape, irregular contours and the presence of calcifications [5,6,12]. In our study, these features were found to be highly suspicious for malignancy as can be seen from the odds ratios, sensitivities, specificities, PPV and NPV.…”

Section: Discussionsupporting

confidence: 68%

“…Although this approach makes it possible to stratify nodules into categories, it can be difficult to assign every thyroid nodule into the equation proposed in clinical practice. To further achieve a practical tool in the hands of sonographers in analysing thyroid nodules and to improve communication between radiologists and clinicians, Russ et al [12] proposed a TIRADS classification that was further modified after feedback from those who used it [13].…”

Section: Introductionmentioning

confidence: 99%

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Reliability of Thyroid Imaging Reporting and Data System (TIRADS) Classification in Differentiating Benign from Malignant Thyroid Nodules

Moifo¹,

Takoeta²,

Tambe³

et al. 2013

OJRad

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Background: Ultrasonography (US) is the best diagnostic tool in the initial assessment of thyroid nodule. Giving its appropriateness and accessibility, ultrasound-based thyroid imaging reporting and data systems (TIRADS) classifications have been developed with main goal to standardize reporting and facilitate communication between practitioners, and to indicate when fine-needle aspiration biopsy (FNAB) should be performed. Objective: To determine the reliability of Russ' modified TIRADS classification in predicting thyroid malignancy. Materials and Methods: It was a cross sectional study carried out at Centre Hospitalier de Lagny, Marne La Vallée (France). Consecutive records of patients with focal thyroid nodules on ultrasound (US) for which US-guided FNAB was performed and pathology results were available, from January 2007 to August 2012, were selected for review. The risk of malignancy of each TIRADS category was determined and correlation with pathology assessed. Statistical performances of some US features were also assessed. The threshold for statistical significance was set at 0.05. Results: A total of 430 records of patients were eligible. Twenty-three out of 430 (5.3%) nodules were malignant. The risk of malignancy of the TIRADS categories were as follows: TIRADS 2 0%, TIRADS 3 2.2%, TIRADS 4A 5.9%, TIRADS 4B 57.9%, TIRADS 5 100% (Gamma statistic = 0.85; Spearman correlation = 0.30, Pearson's R = 0.37, p < 0.001). Some US features were associated with a higher risk of malignancy: irregular contours (OR = 22.4), taller-than-wide shape (OR = 19.5), microcalcifications (OR = 15.2), and marked hypoechogenicity (OR = 12.7). Conclusion: Russ' modified TIRADS classification is reliable in predicting thyroid malignancy. More evidence is nevertheless necessary for widespread adoption and use.

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Section: Discussionsupporting

confidence: 68%

Section: Introductionmentioning

confidence: 99%

Reliability of Thyroid Imaging Reporting and Data System (TIRADS) Classification in Differentiating Benign from Malignant Thyroid Nodules

Moifo¹,

Takoeta²,

Tambe³

et al. 2013

OJRad

View full text Add to dashboard Cite

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“…11) is thought to correspond either to the capsule of the nodule or to the surrounding capsular vessels, or even sometimes to the adjacent compressed parenchyma. A thin halo reduces the risk of malignancy (DOR of 0.3), while a thick halo or absence of a halo increases it (DOR of 3.4) [33]. Campanella et al [10] reported a high risk of malignancy associated with an absent halo (7.1; 95% CI: 3.7–13.7).…”

Section: Importance Of Other Us Findingsmentioning

confidence: 99%

European Thyroid Association Guidelines for Ultrasound Malignancy Risk Stratification of Thyroid Nodules in Adults: The EU-TIRADS

Russ¹,

Bonnema²,

Erdoğan³

et al. 2017

Eur Thyroid J

968

868

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Thyroid ultrasound (US) is a key examination for the management of thyroid nodules. Thyroid US is easily accessible, noninvasive, and cost-effective, and is a mandatory step in the workup of thyroid nodules. The main disadvantage of the method is that it is operator dependent. Thyroid US assessment of the risk of malignancy is crucial in patients with nodules, in order to select those who should have a fine needle aspiration (FNA) biopsy performed. Due to the pivotal role of thyroid US in the management of patients with nodules, the European Thyroid Association convened a panel of international experts to set up European guidelines on US risk stratification of thyroid nodules. Based on a review of the literature and on the American Association of Clinical Endocrinologists, American Thyroid Association, and Korean guidelines, the panel created the novel European Thyroid Imaging and Reporting Data System, called EU-TIRADS. This comprises a thyroid US lexicon; a standardized report; definitions of benign and low-, intermediate-, and high-risk nodules, with the estimated risks of malignancy in each category; and indications for FNA. Illustrated by numerous US images, the EU-TIRADS aims to serve physicians in their clinical practice, to enhance the interobserver reproducibility of descriptions, and to simplify communication of the results.

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“…First, we proceeded to perform a retrospective study on 500 nodules (4). The sensitivity, specificity, and odds ratio of each US sign were calculated, and a specific vocabulary and a standardized report were established.…”

Section: Introductionmentioning

confidence: 99%

Prospective evaluation of thyroid imaging reporting and data system on 4550 nodules with and without elastography

Russ¹,

Royer²,

Bigorgne³

et al. 2013

European Journal of Endocrinology

282

236

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Objective: To evaluate prospectively the diagnostic accuracy of the thyroid imaging reporting and data system (TI-RADS) and its interobserver agreement and to estimate the reduction of indications of fineneedle aspiration biopsies (FNABs). Design: A prospective comparative study was designed. Methods: In 2 years, 4550 nodules in 3543 patients were prospectively scored using a flowchart and a six-point scale and then submitted to US-FNAB. Results were read according to the Bethesda system. Histopathological results were available for 263 cases after surgery. Sensitivity, specificity, negative predictive value (NPV) and positive predictive value, and accuracy were calculated for the gray-scale score, elastography, and a combination of both methods. Interobserver agreement was calculated using the kappa statistic. The reduction in the number of FNABs was estimated. Results: When compared with cytopathological results, sensitivity, specificity, NPV, and accuracy were 95.7, 61, 99.7, and 62% for the TI-RADS gray-scale score; 74.2, 91.1, 98, and 90% for elastography; and 98.5, 44.7, 99.8, and 48.3% for a combination of both methods respectively. When compared with histopathological results, the sensitivity of the gray-scale score, elastography, and a combination of both methods were 93.2, 41.9, and 96.7% respectively. Interobserver agreement for the six-point scale and the recommendation for biopsy were substantial (k valueZ0.72 and 0.76 respectively). The reduction in the number of FNABs was estimated to be 33.8%. Conclusion: The TI-RADS score has high sensitivity and NPV for the diagnosis of thyroid carcinoma. A hard nodule should always be considered as suspicious for malignancy but elastography cannot be used alone. Combination of elastography with gray-scale can be used to improve sensitivity or specificity. Interobserver agreement and decrease in unnecessary biopsies are significant.

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Le système TIRADS en échographie thyroïdienne

Cited by 110 publications

References 17 publications

Reliability of Thyroid Imaging Reporting and Data System (TIRADS) Classification in Differentiating Benign from Malignant Thyroid Nodules

Reliability of Thyroid Imaging Reporting and Data System (TIRADS) Classification in Differentiating Benign from Malignant Thyroid Nodules

European Thyroid Association Guidelines for Ultrasound Malignancy Risk Stratification of Thyroid Nodules in Adults: The EU-TIRADS

Prospective evaluation of thyroid imaging reporting and data system on 4550 nodules with and without elastography

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