Similarities and Differences Between Thyroid Imaging Reporting and Data Systems
So Jin Yoon1, Dong Gyu Na1, Hye Yun Gwon1, Wooyul Paik1 ... Show all
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Citation: American Journal of Roentgenology. 2019;213: W76-W84. 10.2214/AJR.18.20510
AbstractFull TextReferencesPDFPDF PlusSupplementalAdd to FavoritesPermissionsDownload Citation
ABSTRACT :
OBJECTIVE. The purposes of this study were to identify the similarities and differences among the Korean Thyroid Imaging Reporting and Data System (TIRADS), American College of Radiology (ACR) TI-RADS, and European TIRADS and to compare the diagnostic performance of sonographic fine-needle aspiration (FNA) criteria for detecting malignant thyroid nodules.
MATERIALS AND METHODS. This study included 2274 consecutively evaluated thyroid nodules 1 cm or larger in 1836 patients with final diagnoses from January 2011 to December 2016. US features of the nodules were retrospectively reviewed and classified according to three published guidelines from international societies. We compared the US lexicons, categories, and diagnostic performance of the FNA criteria for malignant nodules among the three reporting systems.
RESULTS. Of the 2274 thyroid nodules, 1974 (86.8%) were benign and 300 (13.2%) were malignant; 93.7% of all malignancies were papillary carcinoma. Most of the US lexicons were similar among the three systems except for the definition of echogenicity of a nodule of mixed echogenicity in European TIRADS. Although the categories had strong correlations (r = 0.777–0.877, all p < 0.001) among the three systems, significant differences were observed in categories 5, 4, and 3 of nodules (all p < 0.001) and in the sensitivity, specificity, and rate of unnecessary FNA of the FNA criteria for malignancy (all p < 0.001).
CONCLUSION. Although the three systems had similarities in most US lexicons, significant differences were observed in the classified categories and diagnostic performance of the FNA criteria for malignancy.
Keywords: imaging, reporting systems, thyroid, TI-RADS, TIRADS
Based on a presentation at the European Society of Radiology 2018 annual meeting, Vienna, Austria.
WEB—
This is a web exclusive article.
References
Previous section
1. Perros P, Boelaert K, Colley S, et al; British Thyroid Association. Guidelines for the management of thyroid cancer. Clin Endocrinol (Oxf) 2014; 81(suppl 1):1–122 [Crossref] [Medline] [Google Scholar]
2. Haugen BR, Alexander EK, Bible KC, et al. 2015 American Thyroid Association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: the American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer. Thyroid 2016; 26:1–133 [Crossref] [Medline] [Google Scholar]
3. Gharib H, Papini E, Garber JR, et al; AACE/ACE/AME Task Force on Thyroid Nodules. American Association of Clinical Endocrinologists, American College of Endocrinology, and Associazione Medici Endocrinologi medical guidelines for clinical practice for the diagnosis and management of thyroid nodules–2016 update. Endocr Pract 2016; 22:622–639 [Crossref] [Medline] [Google Scholar]
4. Shin JH, Baek JH, Chung J, et al; Korean Society of Thyroid Radiology (KSThR) and Korean Society of Radiology. Ultrasonography diagnosis and imaging-based management of thyroid nodules: revised Korean Society of Thyroid Radiology consensus statement and recommendations. Korean J Radiol 2016; 17:370–395 [Crossref] [Medline] [Google Scholar]
5. Tessler FN, Middleton WD, Grant EG, et al. ACR Thyroid Imaging, Reporting and Data System (TI-RADS): white paper of the ACR TI-RADS Committee. J Am Coll Radiol 2017; 14:587–595 [Crossref] [Medline] [Google Scholar]
6. Russ G, Bonnema SJ, Erdogan MF, Durante C, Ngu R, Leenhardt L. European Thyroid Association guidelines for ultrasound malignancy risk stratification of thyroid nodules in adults: the EU-TIRADS. Eur Thyroid J 2017; 6:225–237 [Crossref] [Medline] [Google Scholar]
7. Ha EJ, Na DG, Baek JH, Sung JY, Kim JH, Kang SY. US fine-needle aspiration biopsy for thyroid malignancy: diagnostic performance of seven society guidelines applied to 2000 thyroid nodules. Radiology 2018; 287:893–900 [Crossref] [Medline] [Google Scholar]
8. Middleton WD, Teefey SA, Reading CC, et al. Comparison of performance characteristics of American College of Radiology TI-RADS, Korean Society of Thyroid Radiology TIRADS, and American Thyroid Association guidelines. AJR 2018; 210:1148–1154 [Abstract] [Google Scholar]
9. Horvath E, Majlis S, Rossi R, et al. An ultrasonogram reporting system for thyroid nodules stratifying cancer risk for clinical management. J Clin Endocrinol Metab 2009; 94:1748–1751 [Crossref] [Medline] [Google Scholar]
10. Grant EG, Tessler FN, Hoang JK, et al. Thyroid ultrasound reporting lexicon: white paper of the ACR Thyroid Imaging, Reporting and Data System (TIRADS) Committee. J Am Coll Radiol 2015; 12(12 Pt A):1272–1279 [Crossref] [Medline] [Google Scholar]
11. Na DG, Kim JH, Kim DS, Kim SJ. Thyroid nodules with minimal cystic changes have a low risk of malignancy. Ultrasonography 2016; 35:153–158 [Crossref] [Medline] [Google Scholar]
12. Chen SP, Hu YP, Chen B. Taller-than-wide sign for predicting thyroid microcarcinoma: comparison and combination of two ultrasonographic planes. Ultrasound Med Biol 2014; 40:2004–2011 [Crossref] [Medline] [Google Scholar]
13. Moon WJ, Jung SL, Lee JH, et al; Thyroid Study Group, Korean Society of Neuro- and Head and Neck Radiology. Benign and malignant thyroid nodules: US differentiation—multicenter retrospective study. Radiology 2008; 247:762–770 [Crossref] [Medline] [Google Scholar]
14. Na DG, Baek JH, Sung JY, et al. Thyroid imaging reporting and data system risk stratification of thyroid nodules: categorization based on solidity and echogenicity. Thyroid 2016; 26:562–572 [Crossref] [Medline] [Google Scholar]
15. Kobayashi K, Hirokawa M, Yabuta T, et al. Papillary thyroid carcinoma with honeycomb-like multiple small cysts: characteristic features on ultrasonography. Eur Thyroid J 2013; 2:270–274 [Medline] [Google Scholar]
16. Kim JY, Jung SL, Kim MK, Kim TJ, Byun JY. Differentiation of benign and malignant thyroid nodules based on the proportion of sponge-like areas on ultrasonography: imaging-pathologic correlation. Ultrasonography 2015; 34:304–311 [Crossref] [Medline] [Google Scholar]
17. Park JW, Kim DW, Kim D, Baek JW, Lee YJ, Baek HJ. Korean thyroid imaging reporting and data system features of follicular thyroid adenoma and carcinoma: a single-center study. Ultrasonography 2017; 36:349–354 [Crossref] [Medline] [Google Scholar]
18. Hong MJ, Na DG, Baek JH, Sung JY, Kim JH. Impact of nodule size on malignancy risk differs according to the ultrasonography pattern of thyroid nodules. Korean J Radiol 2018; 19:534–541 [Crossref] [Medline] [Google Scholar]
19. Lauria Pantano A, Maddaloni E, Briganti SI, et al. Differences between ATA, AACE/ACE/AME and ACR TI-RADS ultrasound classifications performance in identifying cytological high-risk thyroid nodules. Eur J Endocrinol 2018; 178:595–603 [Crossref] [Medline] [Google Scholar]
20. Koseoglu Atilla FD, Ozgen Saydam B, Erarslan NA, et al. Does the ACR TI-RADS scoring allow us to safely avoid unnecessary thyroid biopsy? Single center analysis in a large cohort. Endocrine 2018 May 9 [Epub ahead of print] [Google Scholar]
21. Grani G, Lamartina L, Ascoli V, et al. Reducing the number of unnecessary thyroid biopsies while improving diagnostic accuracy: toward the “right” TIRADS. J Clin Endocrinol Metab 2019; 104:95–102 [Medline] [Google Scholar]
22. Choi YJ, Baek JH, Baek SH, et al. Web-based malignancy risk estimation for thyroid nodules using ultrasonography characteristics: development and validation of a predictive model. Thyroid 2015; 25:1306–1312 [Crossref] [Medline] [Google Scholar]
23. Ha SM, Ahn HS, Baek JH, et al. Validation of three scoring risk-stratification models for thyroid nodules. Thyroid 2017; 27:1550–1557 [Crossref] [Medline] [Google Scholar]
Address correspondence to D. G. Na (nndgna@gmail.com).
Read More: https://www.ajronline.org/doi/abs/10.2214/AJR.18.20510
So Jin Yoon1, Dong Gyu Na1, Hye Yun Gwon1, Wooyul Paik1 ... Show all
Share Share
+ Affiliations:
Citation: American Journal of Roentgenology. 2019;213: W76-W84. 10.2214/AJR.18.20510
AbstractFull TextReferencesPDFPDF PlusSupplementalAdd to FavoritesPermissionsDownload Citation
ABSTRACT :
OBJECTIVE. The purposes of this study were to identify the similarities and differences among the Korean Thyroid Imaging Reporting and Data System (TIRADS), American College of Radiology (ACR) TI-RADS, and European TIRADS and to compare the diagnostic performance of sonographic fine-needle aspiration (FNA) criteria for detecting malignant thyroid nodules.
MATERIALS AND METHODS. This study included 2274 consecutively evaluated thyroid nodules 1 cm or larger in 1836 patients with final diagnoses from January 2011 to December 2016. US features of the nodules were retrospectively reviewed and classified according to three published guidelines from international societies. We compared the US lexicons, categories, and diagnostic performance of the FNA criteria for malignant nodules among the three reporting systems.
RESULTS. Of the 2274 thyroid nodules, 1974 (86.8%) were benign and 300 (13.2%) were malignant; 93.7% of all malignancies were papillary carcinoma. Most of the US lexicons were similar among the three systems except for the definition of echogenicity of a nodule of mixed echogenicity in European TIRADS. Although the categories had strong correlations (r = 0.777–0.877, all p < 0.001) among the three systems, significant differences were observed in categories 5, 4, and 3 of nodules (all p < 0.001) and in the sensitivity, specificity, and rate of unnecessary FNA of the FNA criteria for malignancy (all p < 0.001).
CONCLUSION. Although the three systems had similarities in most US lexicons, significant differences were observed in the classified categories and diagnostic performance of the FNA criteria for malignancy.
Keywords: imaging, reporting systems, thyroid, TI-RADS, TIRADS
Based on a presentation at the European Society of Radiology 2018 annual meeting, Vienna, Austria.
WEB—
This is a web exclusive article.
References
Previous section
1. Perros P, Boelaert K, Colley S, et al; British Thyroid Association. Guidelines for the management of thyroid cancer. Clin Endocrinol (Oxf) 2014; 81(suppl 1):1–122 [Crossref] [Medline] [Google Scholar]
2. Haugen BR, Alexander EK, Bible KC, et al. 2015 American Thyroid Association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: the American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer. Thyroid 2016; 26:1–133 [Crossref] [Medline] [Google Scholar]
3. Gharib H, Papini E, Garber JR, et al; AACE/ACE/AME Task Force on Thyroid Nodules. American Association of Clinical Endocrinologists, American College of Endocrinology, and Associazione Medici Endocrinologi medical guidelines for clinical practice for the diagnosis and management of thyroid nodules–2016 update. Endocr Pract 2016; 22:622–639 [Crossref] [Medline] [Google Scholar]
4. Shin JH, Baek JH, Chung J, et al; Korean Society of Thyroid Radiology (KSThR) and Korean Society of Radiology. Ultrasonography diagnosis and imaging-based management of thyroid nodules: revised Korean Society of Thyroid Radiology consensus statement and recommendations. Korean J Radiol 2016; 17:370–395 [Crossref] [Medline] [Google Scholar]
5. Tessler FN, Middleton WD, Grant EG, et al. ACR Thyroid Imaging, Reporting and Data System (TI-RADS): white paper of the ACR TI-RADS Committee. J Am Coll Radiol 2017; 14:587–595 [Crossref] [Medline] [Google Scholar]
6. Russ G, Bonnema SJ, Erdogan MF, Durante C, Ngu R, Leenhardt L. European Thyroid Association guidelines for ultrasound malignancy risk stratification of thyroid nodules in adults: the EU-TIRADS. Eur Thyroid J 2017; 6:225–237 [Crossref] [Medline] [Google Scholar]
7. Ha EJ, Na DG, Baek JH, Sung JY, Kim JH, Kang SY. US fine-needle aspiration biopsy for thyroid malignancy: diagnostic performance of seven society guidelines applied to 2000 thyroid nodules. Radiology 2018; 287:893–900 [Crossref] [Medline] [Google Scholar]
8. Middleton WD, Teefey SA, Reading CC, et al. Comparison of performance characteristics of American College of Radiology TI-RADS, Korean Society of Thyroid Radiology TIRADS, and American Thyroid Association guidelines. AJR 2018; 210:1148–1154 [Abstract] [Google Scholar]
9. Horvath E, Majlis S, Rossi R, et al. An ultrasonogram reporting system for thyroid nodules stratifying cancer risk for clinical management. J Clin Endocrinol Metab 2009; 94:1748–1751 [Crossref] [Medline] [Google Scholar]
10. Grant EG, Tessler FN, Hoang JK, et al. Thyroid ultrasound reporting lexicon: white paper of the ACR Thyroid Imaging, Reporting and Data System (TIRADS) Committee. J Am Coll Radiol 2015; 12(12 Pt A):1272–1279 [Crossref] [Medline] [Google Scholar]
11. Na DG, Kim JH, Kim DS, Kim SJ. Thyroid nodules with minimal cystic changes have a low risk of malignancy. Ultrasonography 2016; 35:153–158 [Crossref] [Medline] [Google Scholar]
12. Chen SP, Hu YP, Chen B. Taller-than-wide sign for predicting thyroid microcarcinoma: comparison and combination of two ultrasonographic planes. Ultrasound Med Biol 2014; 40:2004–2011 [Crossref] [Medline] [Google Scholar]
13. Moon WJ, Jung SL, Lee JH, et al; Thyroid Study Group, Korean Society of Neuro- and Head and Neck Radiology. Benign and malignant thyroid nodules: US differentiation—multicenter retrospective study. Radiology 2008; 247:762–770 [Crossref] [Medline] [Google Scholar]
14. Na DG, Baek JH, Sung JY, et al. Thyroid imaging reporting and data system risk stratification of thyroid nodules: categorization based on solidity and echogenicity. Thyroid 2016; 26:562–572 [Crossref] [Medline] [Google Scholar]
15. Kobayashi K, Hirokawa M, Yabuta T, et al. Papillary thyroid carcinoma with honeycomb-like multiple small cysts: characteristic features on ultrasonography. Eur Thyroid J 2013; 2:270–274 [Medline] [Google Scholar]
16. Kim JY, Jung SL, Kim MK, Kim TJ, Byun JY. Differentiation of benign and malignant thyroid nodules based on the proportion of sponge-like areas on ultrasonography: imaging-pathologic correlation. Ultrasonography 2015; 34:304–311 [Crossref] [Medline] [Google Scholar]
17. Park JW, Kim DW, Kim D, Baek JW, Lee YJ, Baek HJ. Korean thyroid imaging reporting and data system features of follicular thyroid adenoma and carcinoma: a single-center study. Ultrasonography 2017; 36:349–354 [Crossref] [Medline] [Google Scholar]
18. Hong MJ, Na DG, Baek JH, Sung JY, Kim JH. Impact of nodule size on malignancy risk differs according to the ultrasonography pattern of thyroid nodules. Korean J Radiol 2018; 19:534–541 [Crossref] [Medline] [Google Scholar]
19. Lauria Pantano A, Maddaloni E, Briganti SI, et al. Differences between ATA, AACE/ACE/AME and ACR TI-RADS ultrasound classifications performance in identifying cytological high-risk thyroid nodules. Eur J Endocrinol 2018; 178:595–603 [Crossref] [Medline] [Google Scholar]
20. Koseoglu Atilla FD, Ozgen Saydam B, Erarslan NA, et al. Does the ACR TI-RADS scoring allow us to safely avoid unnecessary thyroid biopsy? Single center analysis in a large cohort. Endocrine 2018 May 9 [Epub ahead of print] [Google Scholar]
21. Grani G, Lamartina L, Ascoli V, et al. Reducing the number of unnecessary thyroid biopsies while improving diagnostic accuracy: toward the “right” TIRADS. J Clin Endocrinol Metab 2019; 104:95–102 [Medline] [Google Scholar]
22. Choi YJ, Baek JH, Baek SH, et al. Web-based malignancy risk estimation for thyroid nodules using ultrasonography characteristics: development and validation of a predictive model. Thyroid 2015; 25:1306–1312 [Crossref] [Medline] [Google Scholar]
23. Ha SM, Ahn HS, Baek JH, et al. Validation of three scoring risk-stratification models for thyroid nodules. Thyroid 2017; 27:1550–1557 [Crossref] [Medline] [Google Scholar]
Address correspondence to D. G. Na (nndgna@gmail.com).
Read More: https://www.ajronline.org/doi/abs/10.2214/AJR.18.20510
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