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Multicenter Study
. 2016 Sep-Oct;17(5):811-21.
doi: 10.3348/kjr.2016.17.5.811. Epub 2016 Aug 23.

A Multicenter Prospective Validation Study for the Korean Thyroid Imaging Reporting and Data System in Patients with Thyroid Nodules

Eun Ju Ha  1 , Won-Jin Moon  2 , Dong Gyu Na  3 , Young Hen Lee  4 , Nami Choi  2 , Soo Jin Kim  5 , Jae Kyun Kim  6
Affiliations
Multicenter Study

A Multicenter Prospective Validation Study for the Korean Thyroid Imaging Reporting and Data System in Patients with Thyroid Nodules

Eun Ju Ha et al. Korean J Radiol. 2016 Sep-Oct.

Abstract

Objective: To validate a new risk stratification system for thyroid nodules, the Korean Thyroid Imaging Reporting and Data System (K-TIRADS), using a prospective design.

Materials and methods: From June 2013 to May 2015, 902 thyroid nodules were enrolled from four institutions. The type and predictive value of ultrasonography (US) predictors were analyzed according to the combination of the solidity and echogenicity of nodules; in addition, we determined malignancy risk and diagnostic performance for each category of K-TIRADS, and compared the efficacy of fine-needle aspiration (FNA) with a three-tier risk categorization system published in 2011.

Results: The malignancy risk was significantly higher in solid hypoechoic nodules, as compared to partially cystic or isohyperechoic nodules (each p < 0.001). The presence of any suspicious US features had a significantly higher malignancy risk (73.4%) in solid hypoechoic nodules than in partially cystic or isohyperechoic nodules (4.3-38.5%; p < 0.001). The calculated malignancy risk in K-TIRADS categories 5, 4, 3, and 2 nodules were 73.4, 19.0, 3.5, and 0.0%, respectively; and the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy for malignancy were 95.5, 58.6, 44.5, 96.9, and 69.5%, respectively, in K-TIRADS categories 4 and 5. The efficacy of FNA for detecting malignancy based on K-TIRADS was increased from 18.6% (101/544) to 22.5% (101/449), as compared with the three-tier risk categorization system (p < 0.001).

Conclusion: The proposed new risk stratification system based on solidity and echogenicity was useful for risk stratification of thyroid nodules and the decision for FNA. The malignancy risk of K-TIRADS was in agreement with the findings of a previous retrospective study.

Keywords: Core needle biopsy; Fine needle aspiration; Malignancy risk; Risk stratification; Thyroid cancer; Thyroid imaging reporting and data system; Thyroid neoplasm; Thyroid nodules; Ultrasonography.

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Figures

Fig. 1
Fig. 1. Flow chart of study group.
CNB = core needle biopsy, FNA = fine needle aspiration, US = ultrasonography
See this image and copyright information in PMC

References

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