The impact of the use of the <scp>ACR‐TIRADS</scp> as a screening tool for thyroid nodules in a cancer center

Melo, Rayssa Araruna Bezerra de; Menis, Fabio; Calsavara, Vinicus Fernando; Stefanini, Flávio Scavone; Novaes, Tullio; Saieg, Mauro

doi:10.1002/dc.24904

Cited by 11 publications

(6 citation statements)

References 28 publications

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“…The current study showed an increased malignancy risk with an increasing nodule's ACR-TIRADS level. This comes in line with the studies done by Qi et al (27) and Araruna et al (28) in which a significant trend of a rising malignancy risk was noted as the final TR risk level gradually increased from TR1 to TR5.…”

Section: Discussionsupporting

confidence: 91%

Diagnostic performance of ACR-TIRADS ultrasound lexicon in risk stratification of thyroid nodules

2023

The Egyptian Journal of Hospital Medicine

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Background: Thyroid nodules (TNs) are commonly encountered in clinical settings. Many professional organizations have adopted and published ultrasound-based risk stratification systems (RSSs) as a tool for standardized reporting and evaluation. The American College of Radiology-Thyroid Imaging Reporting and Data System (ACR-TIRADS) Committee in 2017 proposed a white paper with a novel risk stratification system that classifies TNs into 5 morphologic categories on the basis of their ultrasonographic features (echogenicity, composition, margin, shape, and echogenic foci). These features are described and assigned points to obtain a total score that determines the thyroid nodule's TR risk levels (from TR1 to TR5). Objective: The aim of the current study was to assess the value of the ACR Thyroid Imaging Reporting and Data System (ACR-TIRADS) Lexicon in predicting the nature of different thyroid nodules. Patients and methods: A total of 102 subjects (90 female and 12 males; age between 18 and 77 years) with 130 thyroid nodules with a definitive cytopathologic diagnosis on the basis of US-guided FNAB and/or surgery results were enrolled. The mean age was 41.03 (SD 13.09) years, with ages ranging between 18 and 77 years. Our study was carried out between November 2020 and October 2022. Result: The ACR-TIRADS US lexicon's predictive ability in thyroid nodules' risk stratification was assessed. The overall accuracy, sensitivity, specificity, NPV, and PPV were 83.08%, 94.34%, 75.32%, 95.08% and 72.46%, respectively. Conclusions: In everyday practice, ACR-TIRADS classification is a non-invasive, safe, reliable, and applicable tool for evaluating thyroid nodules, standardizing report structure, and reducing inconsistencies with thyroid nodules' interpretation.

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Section: Discussionsupporting

confidence: 91%

Diagnostic performance of ACR-TIRADS ultrasound lexicon in risk stratification of thyroid nodules

2023

The Egyptian Journal of Hospital Medicine

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“…The aim of this study has been to evaluate the diagnostic performance of ACR TI-RADS scoring systems that have cytology and histology as reference. Taking into account the former, ACR TI-RADS showed a comparable performance in terms of RON as previously reported [ 22 ]. In fact, a significant trend towards an increase of RON was observed in ACR TI-RADS when going from the lower- to the higher-risk categories, in line with what was previously described in the current literature, and, in particular, about the initial ACR TI-RADS white paper [ 23 ].…”

Section: Discussionsupporting

confidence: 81%

Evaluation of the Performance of ACR TI-RADS Also Considering Those Nodules with No Indication of FNAC: A Single-Center Experience

Amendola

Sellasie

Pedicini

et al. 2023

JCM

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Background: Several US risk stratification score systems (RSSs) have been developed to standardize a thyroid nodule risk of malignancy. It is still a matter of debate which RSS is the most reliable. The purpose of this study is to evaluate: (1) the concordance between the American College of Radiology TI-RADS (ACR TI-RADS) and fine needle aspiration cytology (FNAC), (2) the cancer rate in the ACR TI-RADS categories, (3) the characteristics of nodules evaluated by FNAC even if not formally indicated according to ACR TI-RADS (‘not indicated FNACs”). Methods: From January 2021 to September 2022, patients attending the Endocrinology Unit of the CTO Hospital of Rome for evaluation of thyroid nodules were included. Results: 830 nodules had negative cytology, belonging to TIR2 and TIR1C. One hundred and thirteen nodules were determined to be suspicious for or consistent with malignancy belonging to TIR3B/TIR4/TIR5. Of this last group, 94% were classified as TR4/TR5 nodules. In total, 87/113 underwent surgery. Among these, 73 had histologically proven cancer, 14 turned out to be benign. “Not indicated FNACs” was 623. Among these, 42 cancers were present. Conclusions: This study confirmed the diagnostic power of ACR TI-RADS. In addition, these data suggest revising the ACR TI-RADS indication to FNAC, especially for TR4.

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“…Of the 951 articles identified via the database search, 35 met eligibility criteria (Figure 1). 18–52 We found that the inter‐rater reliability amongst independent reviewers for the abstract screening and full‐text review stages was 0.704 (95% CI: 0.628, 0.781) and 0.766 (95% CI: 0.630, 0.903), respectively.…”

Section: Resultsmentioning

confidence: 92%

Inter‐Rater Reliability of Thyroid Ultrasound Risk Criteria: A Systematic Review and Meta‐Analysis

et al. 2022

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Objective: The most commonly employed diagnostic criteria for identifying thyroid nodules include Thyroid Imaging and Reporting Data System (TI-RADS) and American Thyroid Association (ATA) guidelines. The purpose of this systematic review and meta-analysis is to determine the inter-rater reliability of thyroid ultrasound criteria.Methods: We performed a library search of MEDLINE (Ovid), EMBASE (Ovid), and Web of Science for full-text articles published from January 2005 to June 2022. We included full-text primary research articles that used TI-RADS and/or ATA guidelines to evaluate thyroid nodules in adults. These included studies must have calculated inter-rater reliability using any validated metric. The Quality Appraisal for Reliability Studies (QAREL) was used to assess study quality. We planned for a random-effects meta-analysis, in addition to covariate and publication bias analyses. This study was performed in accordance with Preferred Reporting Items for a Systematic Review and Meta-analysis guidelines and registered prior to conduction (International prospective register of systematic reviews-PROSPERO: CRD42021275072).Results: Of the 951 articles identified via the database search, 35 met eligibility criteria. All studies were observational. The most commonly utilized criteria were ACR Thyroid Imaging and Reporting Data System (TI-RADS) and/or ATA criteria, while the majority of studies employed Κ statistics. For ACR TI-RADS, the pooled Κ was 0.51 (95% confidence interval [CI]: 0.42, 0.57; n = 7) while for ATA, the pooled Κ was 0.52 (95% CI: 0.37, 0.67; n = 3). Due to the small number of studies, covariate or publication bias analyses were not performed.Conclusion: Ultrasound criteria demonstrate moderate inter-rater reliability, but these findings are impacted by poor study quality and a lack of standardization.

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The impact of the use of the ACR‐TIRADS as a screening tool for thyroid nodules in a cancer center

Cited by 11 publications

References 28 publications

Diagnostic performance of ACR-TIRADS ultrasound lexicon in risk stratification of thyroid nodules

Diagnostic performance of ACR-TIRADS ultrasound lexicon in risk stratification of thyroid nodules

Evaluation of the Performance of ACR TI-RADS Also Considering Those Nodules with No Indication of FNAC: A Single-Center Experience

Inter‐Rater Reliability of Thyroid Ultrasound Risk Criteria: A Systematic Review and Meta‐Analysis

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