Ultrasonography-Based Classification and Reporting System for the Malignant Risk of Thyroid Nodules

Abstract

Objective: The aim of this study was to test the predictive value of a Thyroid Imaging Reporting and Data System (TI-RADS) for malignant thyroid nodules.Methods: Ultrasonographic data was examined for 910 thyroid nodules with histopathologically confirmed diagnoses. Nodules were placed into incomplete (category 0) or complete final categories (1, 2, 3a, 3b, 3c, 4, or 5) based on the presence and number of ultrasonographic features of malignancy, and the predictive value for the malignancy of nodules in categories 2 4 was assessed. Results:The overall rate of malignancy among thyroid nodules included in the study was 59.34%. The rate of malignancy gradually increased according to TI-RADS categories as follows: category 2, 5.4%; category 3 (a c), 36% to 92%; and category 4, 99.0%. When nodules of category 2 were counted as benign, the reliability of the TI-RADS classification for determining the risk of malignancy was as follows; sensitivity, 98.15%; specificity, 47.84%; positive predictive value, 73.31%; negative predictive value, 94.65%; and odds ratio, 48.61. Conclusions:The TI-RADS classification used in this study is relatively simple and provides a reliable measure of the risk of malignancy of thyroid nodules. (J Nippon Med Sch 2017; 84: 118 124)

Taller-than-wide Thyroid Nodules With Microcalcifications Are at High Risk of Malignancy

“…It should also be pointed out that marked hypoechogenecity was common in our malignant nodules, with an OR of 6.5, higher than previously reported (24) indicating an increased risk of malignancy, whereas intranodular vascularity or illdefined margins were adequate for determining a high risk of malignancy. When hypoechogenecity was evaluated in combination with microcalcifications and with the shape, our results showed no improvement of sensitivity or higher AUC (data not shown).…”

Diagnostic Reliability of the American College of Radiology Thyroid Imaging Reporting and Data System in Royal Commission Hospital, Kingdom of Saudi Arabia

“…On the other hand a higher percentage of sensitivity was documented in different countries across the globe: Philippines (100%) [35], China (92.7%) [17] and (98.15%) [18], Korea (95.5%) [21] and (96.6%) [20] and Egypt (98.3%) [36]. In our study, the specificity of the ACRTI-RADS for predicting the risk of malignancy was lower than that reported in many different countries: obtained in Korea (58.6%) [21] and (52.9%) [20], Brazil (51.4%) [15], China (47.84%) [18] and (89.1%) [19], Philippines (52.2%) [36], Malaysia (51.1%) [22] and (70.7%) [17], Singapore (90.4%) [16], Italy (57.2 %) [29] and 58.9% [33], Egypt (90.9%) [36] and Turkey (97.5%) [34]. In the current study, the positive predictive value of the thyroid ACR TI-RADS was higher than that obtained in Italy (12.8 %) [29] and Philippines (16.5%) [35], but lower than that found in Chile (49%) [14], China (73.31%) [18] and, Korea (44.5%) [21] and Turkey (63.3%) [34].…”

“…The sensitivity of ACRTI-RADS for predicting the risk of malignancy was markedly higher than that seen in Brazil (90%) [15] Chile (88%) [14] China (77.3%) [19], Malaysia (85.7%) [22] Italy (67.6%) [29] and 58.9% [33], Israel 86% [13] and Turkey (76%) [34]. On the other hand a higher percentage of sensitivity was documented in different countries across the globe: Philippines (100%) [35], China (92.7%) [17] and (98.15%) [18], Korea (95.5%) [21] and (96.6%) [20] and Egypt (98.3%) [36]. In our study, the specificity of the ACRTI-RADS for predicting the risk of malignancy was lower than that reported in many different countries: obtained in Korea (58.6%) [21] and (52.9%) [20], Brazil (51.4%) [15], China (47.84%) [18] and (89.1%) [19], Philippines (52.2%) [36], Malaysia (51.1%) [22] and (70.7%) [17], Singapore (90.4%) [16], Italy (57.2 %) [29] and 58.9% [33], Egypt (90.9%) [36] and Turkey (97.5%) [34].…”

“…Applying ACR TI-RADS criteria can minimize the number of ultrasound-guided FNACs performed on benign nodules [13]. Hence, many studies have assessed ACR TI-RADS to determine its sensitivity, specificity, positive predictive value, negative predictive value, accuracy rate and receiver operating characteristic (ROC) curves [14], [15], [16], [17], [18], [19], [20], [21], [22]. Thyroid ultrasound is a reliable non-invasive, practical method [6], [23]; it is accessible and has a low capital cost [6].…”

The Comparatıve Evaluatıon of Fine Needle Aspiration Biopsy Results of the Cases Which Are Atypia of Undetermined Significance and the Surgical Material Results

“…Kategori 4'te 4 ve daha fazla malignite işareti sayılabilecek özellik mevcuttur. Kategori 5 ise İİAB ile malign olduğu kanıtlanmış nodülleri içerir (10). Bir çalışmada İİAB sonucu önemi belirsiz atipi olarak bildirilen ve ultrasonografik olarak malignite şüphesi içeren iki bulgu olan hastalarda ameliyat materyallerinde kanser olarak raporlanma oranı %66,7 olarak bildirilmiştir (11).…”