Reproducibility and Interobserver Agreement of Different Thyroid Imaging and Reporting Data Systems (TIRADS).
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ABSTRACT: Introduction
A number of classification systems (TIRADS) have been developed to estimate the likelihood of malignancy in thyroid nodules, but their reproducibility is yet to be assessed. We evaluated the interobserver variability and diagnostic performance of the TIRADS in Kwak's modification (Kw-TIRADS) and European TIRADS (EU-TIRADS).Methods
Two independent specialists, blinded concerning the morphology of the nodules, evaluated ultrasound images of 153 thyroid nodules identified in 149 patients at multiple time points.Results
The interobserver agreement (Cohen's κ) was 0.52 and 0.67 for Kw-TIRADS and EU-TIRADS, respectively, and rated as substantial. There were strong correlations between Kw-TIRADS and EU-TIRADS for the two observers with Spearman's coefficients of 0.731 (p = 0.00025) and 0.661 (p = 0.0012), respectively. Sensitivity of Kw-TIRADS for the diagnosis of thyroid cancer was 95-92.31% and that of EU-TIRADS was 92.31-89.74%, with specificity of about 60% for both TIRADS.Conclusion
Despite the wide variability in the description of single ultrasonographic features, both Kw-TIRADS and EU-TIRADS may be a useful diagnostic tool in clinical practice.
SUBMITTER: Sych YP
PROVIDER: S-EPMC8077651 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:PurposeTo explore the characteristics of C-TIRADS by comparing it with ACR-TIRADS, Kwak-TIRADS, KSThR-TIRADS and EU-TIRADS.MethodsA total of 1096 nodules were collected from 884 patients undergoing thyroidectomy in our center between May 2018 and December 2020. Divided the nodules into two groups: ">10mm" and "≤10mm". Ultrasound characteristics of each nodule were observed and recorded by 2 doctors, then classified based on ACR-TIRADS, Kwak-TIRADS, KSThR-TIRADS, EU-TIRADS, and C-TIRADS.ResultsA total of 682 benign nodules cases (62.23%) and 414 malignant nodules cases (37.77%) were identified. The ICC value of each guideline was:0.937(ACR-TIRADS), 0.858(EU-IRADS), 0.811(Kwak-TIRADS), 0.835(KTA/KSThR-TIRADS) and 0.854(C-TIRADS). The nodule malignancy rates in the groups(Kwak-TIRADS 4B, C-TIRADS 4B、4C) of two sizes were significantly different (all p<0.05). There was no statistical difference in the other grades of two sizes (all p>0.05). Unnecessary biopsy rates were the lowest in C-TIRADS (49.02% p<0.001). Furthermore, Kwak-TIRADS had the highest sensitivity and NPV (89.9%, 91.0%, all p<0.05), while C-TIRADS had the highest specificity and PPV (82.3%, 69.2%, all p<0.05). C-TIRADS and Kwak-TIRADS had the highest accuracy (76.0%, 72.5%, P=0.071). The AUCs of the 5 guidelines were C-TIRADS(0.816, P<0.05), Kwak-TIRADS(0.789, P<0.05) KTA/KSThR-TIRADS and ACR-TIRADS(0.773, 0.763, P=0.305), EU-TIRADS(0.734, P<0.05). The AUCs of the five guidelines were not statistically different between "nodules>10mm" and "nodules ≤ 10mm" (all P>0.05).ConclusionsAll five guides showed excellent interobserver agreement. C-TIRADS was slightly efficient than Kwak-IRADS, KTA/KSThR-TIRADS and ACR-TIRADS, and had greater advantages than EU-TIRADS. The diagnostic abilities of the five guidelines for "nodules ≤ 10mm" were not inferior to that of "nodules> 10mm". C-TIRADS is simple and easy to implement and can provide effective thyroid tumor risk stratification for thyroid nodule diagnosis, especially in China.
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Project description:Background The incidence of thyroid lumps is more and more high in population, and most biopsies of thyroid nodules are benign. To develop a practical risk stratification system based on five ultrasound features to stratify the malignancy risk of thyroid neoplasms. Methods This retrospective investigation enrolled 999 consecutive patients with 1,236 thyroid nodules who underwent ultrasound screening. Fine-needle aspiration and/or surgery was performed, and pathology results were obtained at the Seventh Affiliated Hospital of Sun Yat-sen University in Shenzhen, China, which is a tertiary referral center, from May 2018 to February 2022. Each thyroid nodule’s score was calculated based on five ultrasound features: composition, echogenicity, shape, margin, and echogenic foci. Additionally, each nodule’s malignancy rate was calculated. The chi-square test was used to test whether the malignancy rate was different among the three subcategories (scores of 4–6, 7–8, and 9 or more) of thyroid nodules. We proposed the revised Thyroid Imaging Reporting and Data System (R-TIRADS), and its sensitivity and specificity were compared to the two existing systems [the American College of Radiology TIRADS (ACR TIRADS) and the Korean Society of Thyroid Radiology TIRADS (K-TIRADS)]. Results The final dataset consisted of 425 nodules from 370 patients. The malignancy rates of three subcategories [malignancy rate: 28.8% (scores from 4–6), 64.7% (scores from 7–8), and 84.2% (scores of 9 or more)] were significantly different (P<0.01). The unnecessary biopsy rates of the three systems (ACR TIRADS, R-TIRADS, and K-TIRADS) were 28.7%, 25.2%, and 14.8%, respectively. The R-TIRADS presented better diagnostic performance than the ACR TIRADS or K-TIRADS [area under the curve: 0.79 (95% CI: 0.74–0.83) vs. 0.69 (95% CI: 0.64–0.75), P=0.046; 0.79 (95% CI: 0.74–0.83) vs. 0.66 (95% CI: 0.60–0.71), P=0.041, respectively]. The R-TIRADS had the highest sensitivity [0.746 (95% CI: 0.689–0.803)], followed by the K-TIRADS [0.399 (95% CI: 0.335–0.463), P=0.000] and ACR TIRADS [0.377 (95% CI: 0.314–0.441), P=0.000]. Conclusions The R-TIRADS enables radiologists to diagnose thyroid nodules efficiently, and the number of unnecessary fine-needle aspirations can be considerably reduced.
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