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Comparative Study
. 2017 Sep 14;7(1):11560.
doi: 10.1038/s41598-017-11863-0.

Malignancy risk stratification of thyroid nodules: comparisons of four ultrasound Thyroid Imaging Reporting and Data Systems in surgically resected nodules

Ying Wang  1   2   3   4 , Kai-Rong Lei  2 , Ya-Ping He  1   4 , Xiao-Long Li  1   3   4 , Wei-Wei Ren  1   3   4 , Chong-Ke Zhao  1   3   4 , Xiao-Wan Bo  1   3   4 , Dan Wang  1   3   4 , Cheng-Yu Sun  1   2   3   4 , Hui-Xiong Xu  5   6   7
Affiliations
Comparative Study

Malignancy risk stratification of thyroid nodules: comparisons of four ultrasound Thyroid Imaging Reporting and Data Systems in surgically resected nodules

Ying Wang et al. Sci Rep. .

Abstract

To compare the efficiency of four different ultrasound (US) Thyroid Imaging Reporting and Data Systems (TI-RADS) in malignancy risk stratification in surgically resected thyroid nodules (TNs). The study included 547 benign TNs and 464 malignant TNs. US images of the TNs were retrospectively reviewed and categorized according to the TI-RADSs published by Horvath E et al. (TI-RADS H), Park et al. (TI-RADS P), Kwak et al. (TI-RADS K) and Russ et al. (TI-RADS R). The diagnostic performances for the four TI-RADSs were then compared. At multivariate analysis, among the suspicious US features, marked hypoechogenicity was the most significant independent predictor for malignancy (OR: 15.344, 95% CI: 5.313-44.313) (P < 0.05). Higher sensitivity was seen in TI-RADS H, TI-RADS K, TI-RADS R comparing with TI-RADS P (P < 0.05 for all), whereas the specificity, accuracy and area under the ROC curve (Az) of TI-RADS P were the highest (all P < 0.05). Higher specificity, accuracy and Az were seen in TI-RADS K compared with TI-RADS R (P = 0.003). With its higher sensitivity, TI-RADS K, a simple predictive model, is practical and convenient for the management of TNs in clinical practice. The study indicates that there is a good concordance between TI-RADS categories and histopathology.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Figure 1
Figure 1
(a) Nodular goiter. Predominantly cystic nodule. TI-RADS H: 3; TI-RADS P: 1; TI-RADS K: 2; TI-RADS R: 3. (b) Follicular adenona. Solid and isoechoic nodule. TI-RADS H: 4a; TI-RADS P: 2; TI-RADS K: 4a; TI-RADS R: 3. (c) Papillary thyroid carcinoma. Solid and iso-hypoechoic nodule with microcalcification and hypoechoic halo, TI-RADS H: 4c; TI-RADS P: 4; TI-RADS K: 4b; TI-RADS R: 4b. (d) Papillary thyroid carcinoma. Solid and hypoechoic nodule with taller than wide shape, microlobulated margin, and microcalcification. TI-RADS H: 4c; TI-RADS P: 4; TI-RADS K: 5; TI-RADS R: 5. (e) Papillary thyroid carcinoma. Solid and marked hypoechoic nodule with microlobulated margin. TI-RADS H: 4b; TI-RADS P: 4; TI-RADS K: 4c; TI-RADS R: 4b. (f) Papillary thyroid carcinoma. Solid and hypoechoic nodule with disperse microcalcifications. TI-RADS H: 4c; TI-RADS P: 4; TI-RADS K: 4c; TI-RADS R: 4b. (g) Papillary thyroid carcinoma. Solid and hypoechoic nodule with microlobulated and mixed calcification. TI-RADS H: 4c; TI-RADS P: 5; TI-RADS K: 4c; TI-RADS R: 5. (h,i) Follicular thyroid carcinoma. Predominantly solid nodule with hypoechoic halo and hypervascular. TI-RADS H: 4c; TI-RADS P: 2; TI-RADS K: 3; TI-RADS R: 4a.
Figure 2
Figure 2
ROC curves of four TI-RADSs. Higher sensitivity was seen for TI-RADS H, TI-RADS K, TI-RADS R in comparison with TI-RADS P. Specifcity for the TI-RADS P was the highest compared with the other versions.
See this image and copyright information in PMC

References

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