Thyroid imaging reporting and data system score combined with <scp>B</scp>ethesda system for malignancy risk stratification in thyroid nodules with indeterminate results on cytology

Maia, Frederico Fernandes Ribeiro; Matos, Patrícia Francisca de; Pavin, Elizabeth João; Zantut-Wittmann, Denise Engelbrecht

doi:10.1111/cen.12525

Cited by 59 publications

(58 citation statements)

References 27 publications

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“…Previously, the detection of any degree of internal blood flow was positively related to an increased likelihood of malignancy (17,28,33). However, in our study, this finding was not a useful predictor of malignancy.…”

Section: Discussioncontrasting

confidence: 81%

“…Later, Russ and cols. (12) validated their own proposed classification in 4550 nodules, which was further validated in other 242 nodules (17).…”

Section: Introductionmentioning

confidence: 72%

“…Since the size of microcalcifications has been reported to range from 0.5-3.0 mm in different studies (8-11,21;25,26,30), one should expect an overlap between micro-and macrocalcifications. However, macrocalcification as a possible suspicious feature has not been included in previous TI-RADS classifications (7,9,11,12,17). It is important to note that presence of macrocalcification is generally associated with an increased risk of malignancy (5,25,29).…”

Section: Discussionmentioning

confidence: 99%

“…We included Doppler flow analysis in this proposed TI-RADS, as done in other studies (7,10,17). Previously, the detection of any degree of internal blood flow was positively related to an increased likelihood of malignancy (17,28,33).…”

Section: Discussionmentioning

confidence: 99%

“…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%

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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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Section: Discussioncontrasting

confidence: 81%

“…Later, Russ and cols. (12) validated their own proposed classification in 4550 nodules, which was further validated in other 242 nodules (17).…”

Section: Introductionmentioning

confidence: 72%