Dataset Information

Diagnostic and therapeutic performances of three score-based Thyroid Imaging Reporting and Data Systems after application of equal size thresholds.

ABSTRACT:

Background

The aim of this study was to explore the diagnostic and therapeutic performances of the artificial intelligence (AI), American College of Radiology (ACR), and Kwak Thyroid Imaging Reporting and Data Systems (TIRADSs) using the size thresholds for fine needle aspiration (FNA) and follow-up defined in the ACR TIRADS.

Methods

This retrospective study included 3,833 consecutive thyroid nodules identified in 2,590 patients from January 2010 to August 2017. Ultrasound (US) features were reviewed using the 2017 white paper of the ACR TIRADS. US categories were assigned according to the ACR/AI and Kwak TIRADS. We applied the thresholds for FNA and follow-up defined in the ACR TIRADS to the Kwak TIRADS. The diagnostic and therapeutic performances were calculated and compared using the McNemar or DeLong methods.

Results

The AI TIRADS had higher specificity, accuracy, and area under the curve (AUC) than did the ACR and Kwak TIRADS (specificity: 64.6% vs. 57.4% and 52.69%; accuracy: 78.5% vs. 75.4% and 73.0%; AUC: 88.2% vs. 86.6% and 86.0%; all P values <0.05). Meanwhile, the AI TIRADS had a lower FNA rate (FNAR), unnecessary FNA rate (UFR), and follow-up rate (FUR) than did the ACR and Kwak TIRADS using the size thresholds of the ACR TIRADS (specificity: 30.9% vs. 34.4% and 36.9%; accuracy: 41.1% vs. 47.8% and 48.7%; AUC: 34.2% vs. 37.7% and 41.0%; all P values <0.05). In addition, the Kwak TIRADS incorporating the size thresholds of the ACR TIRADS was almost similar to the ACR TIRADS in diagnostic and therapeutical performance.

Conclusions

The ACR TIRADS can be simplified, which potentially enhances its diagnostic and therapeutic performance. The method of score-based TIRADS (counting in the Kwak TIRADS and weighting in the ACR and AI TIRADS) might not determine the diagnostic and therapeutic performances of the TIRADS. Thus, we propose choosing a straightforward and practical TIRADS in daily practice.

SUBMITTER: Si CF

PROVIDER: S-EPMC10102798 | biostudies-literature | 2023 Apr

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Diagnostic and therapeutic performances of three score-based Thyroid Imaging Reporting and Data Systems after application of equal size thresholds.

Si Cai-Feng CF Fu Chao C Cui Yi-Yang YY Li Jing J Huang Yuan-Jing YJ Cui Ke-Fei KF

Quantitative imaging in medicine and surgery 20230223 4

<h4>Background</h4>The aim of this study was to explore the diagnostic and therapeutic performances of the artificial intelligence (AI), American College of Radiology (ACR), and Kwak Thyroid Imaging Reporting and Data Systems (TIRADSs) using the size thresholds for fine needle aspiration (FNA) and follow-up defined in the ACR TIRADS.<h4>Methods</h4>This retrospective study included 3,833 consecutive thyroid nodules identified in 2,590 patients from January 2010 to August 2017. Ultrasound (US) fe ...[more]

PMID: 37064344

Similar Datasets

Project description:BackgroundThe lack of standardization in risk stratification systems (RSSs) has led to uncertainty in selecting the most effective RSS for diagnosing malignancy risk in thyroid nodules. Therefore, the aim of this study was to compare the diagnostic performance of four current score-based RSSs according to thyroid nodule size, with the goal of determining the most effective RSS and aiding in clinical decision-making.MethodsBetween July 2013 and January 2019, a total of 2,667 consecutive patients presenting with 3,944 thyroid nodules were pathologically diagnosed after thyroidectomy and/or ultrasound (US)-guided fine-needle aspiration (FNA). These nodules were retrospectively dichotomized into two groups: small nodules (<1 cm) and large nodules (≥1 cm). The four RSSs were used to assign US categories, and the diagnostic performances were computed and compared based on the size of thyroid nodules, both before and after the application of size thresholds for biopsy.ResultsAfter thyroidectomy or biopsy, 1,781 (45.2%) thyroid nodules were found to be malignant. (I) After applying size thresholds for biopsy in ≥1 cm nodules, the highest specificity, accuracy, area under the curve (AUC) and the lowest FNA rate and unnecessary FNA rate were observed in the Artificial Intelligence-Thyroid Imaging Reporting And Data System (AI-TIRADS) (66.1%, 75.3%, 0.785, 55.1%, and 38.6%, respectively, P<0.05 for all). (II) Before applying size thresholds for biopsy in ≥1 cm nodules, the FNA rate and unnecessary FNA rate of the four RSSs were lower they were after the application of the size threshold: American College of Radiology Thyroid Imaging Reporting and Data System (ACR-TIRADS), 59.1% versus 61.4%, 39.8% versus 45.4%; AI-TIRADS, 52.3% versus 55.1%, 34.0% versus 38.6%; TIRADS issued by Kwak et al. (Kwak-TIRADS), 52.5% versus 76.1%, 34.4% versus 52.1%; Chinese Thyroid Imaging Reporting and Data System (C-TIRADS), 51.5% versus 66.2%, 34.4% versus 50.1% (P<0.05 for all). (III) The small nodules showed higher sensitivity and lower specificity than the large nodules (ACR-TIRADS, 97.7% versus 95.5%, 46.2% versus 62.5%; AI-TIRADS, 97.2% versus 92.7%, 49.9% versus 71.6%; Kwak-TIRADS, 97.2% versus 92.5%, 49.7% versus 71.3%; C-TIRADS, 94.2% versus 90.7%, 55.0% versus 71.8%, respectively, all P<0.05).ConclusionsA potential effective strategy for managing large nodules in the current score-based RSSs could be to rely solely on US categories rather than size thresholds for biopsy. Additionally, the diagnostic performance of small nodules showed higher sensitivity and lower specificity compared to large nodules before applying size thresholds for biopsy. These findings suggest a possible new management strategy for large nodules and provide a basis for the managing small nodules.

Project description:The aim was to compare the usefulness of selected thyroid sonographic risk-stratification systems in the diagnostics of nodules with indeterminate/suspicious cytology or unequivocal cytology in a population with a history of iodine deficiency. The diagnostic efficacy of ACR-TIRADS (the American College of Radiology Thyroid Imaging Reporting and Data Systems), EU-TIRADS (European Thyroid Association TIRADS), Korean-TIRADS, Kwak-TIRADS, AACE/ACE-AME-guidelines (American Association of Clinical Endocrinologists/ American College of Endocrinology-Associazione Medici Endocrinologi guidelines) and ATA-guidelines (American Thyroid Association guidelines) was evaluated in 1000 nodules with determined histopathological diagnosis: 329 FLUS/AUS (10.6% cancers), 167 SFN/SHT (11.6% cancers), 44 SM (77.3% cancers), 298 BL (benign lesions), 162 MN (malignant neoplasms). The percentage of PTC (papillary thyroid carcinoma) among cancers was higher in Bethesda MN (86.4%) and SM (suspicion of malignancy) nodules (91.2%) than in FLUS/AUS (57.1%, p < 0.005) and SFN/SHT (suspicion of follicular neoplasm/ suspicion of Hürthle cell tumor) nodules (36.8%, p < 0.001). TIRADS efficacy was higher for MN (AUC: 0.827-0.874) and SM nodules (AUC: 0.775-0.851) than for FLUS/AUS (AUC: 0.655-0.701) or SFN/SHT nodules (AUC: 0.593-0.621). FLUS/AUS (follicular lesion of undetermined significance/ atypia of undetermined significance) nodules assigned to a high risk TIRADS category had malignancy risk of 25%. In the SFN/SHT subgroup none TIRADS category changed nodule's malignancy risk. EU-TIRADS and AACE/ACE-AME-guidelines would allow diagnosing the highest number of PTC, FTC (follicular thyroid carcinoma), HTC (Hürthle cell carcinoma), MTC (medullary thyroid carcinoma). The highest OR value was for Kwak-TIRADS (12.6) and Korean-TIRADS (12.0). Conclusions: TIRADS efficacy depends on the incidence of PTC among cancers. All evaluated TIRADS facilitate the selection of FLUS/AUS nodules for the surgical treatment but these systems are not efficient in the management of SFN/SHT nodules.

Dataset Information

Diagnostic and therapeutic performances of three score-based Thyroid Imaging Reporting and Data Systems after application of equal size thresholds.

Background

Methods

Results

Conclusions

Publications

Diagnostic and therapeutic performances of three score-based Thyroid Imaging Reporting and Data Systems after application of equal size thresholds.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets