Differences among the Thyroid Imaging Reporting and Data System proposed by Korean, the American College of Radiology and the European Thyroid Association in the diagnostic performance of thyroid nodules

Yi-Xin Shi; Lin Chen; Ying-Chun Liu; Jia Zhan; Xue-Hong Diao; Liang Fang; Yue Chen

doi:10.21037/tcr-19-2870

Differences among the Thyroid Imaging Reporting and Data System proposed by Korean, the American College of Radiology and the European Thyroid Association in the diagnostic performance of thyroid nodules

Transl Cancer Res. 2020 Aug;9(8):4958-4967. doi: 10.21037/tcr-19-2870.

Authors

Yi-Xin Shi^{1

2}, Lin Chen^{1

2}, Ying-Chun Liu^{1

2}, Jia Zhan^{1

2}, Xue-Hong Diao^{1

2}, Liang Fang^{1

2}, Yue Chen^{1

2}

Affiliations

¹ Department of Ultrasound, Huadong Hospital, Fudan University, Shanghai, China.
² Shanghai Key Laboratory of Clinical Geriatric Medicine, Shanghai, China.

Abstract

The aim of this study was to evaluate the diagnostic performance of the Thyroid Imaging Reporting and Data System (TIRADS) in the forms proposed by Kwak (K-TIRADS), the American College of Radiology (ACR-TIRADS) and the European Thyroid Association (EU-TIRADS). A total of 846 thyroid nodules were evaluated by K-TIRADS, ACR-TIRADS and EU-TIRADS. All the ultrasound data were analyzed and classified according to the criteria of the three systems. In addition, we calculated the risk of malignancy and plotted receiver operating characteristic (ROC) curves. Moreover, the diagnostic efficacy for malignancy were compared. Of the 846 thyroid nodules, 316 were malignant nodules and 530 were benign nodules. The areas under the ROC curves of K-TIRADS (0.827) and ACR-TIRADS (0.817) were not significantly different (P=0.2425); however, they were greater than that of EU-TIRADS (0.758) (P=0.000). The sensitivity of K-TIRADS (94.94%) was higher than that of ACR-TIRADS (61.08%) or EU-TIRADS (58.86%) (P=0.000), while ACR-TIRADS (89.62%) and EU-TIRADS (83.21%) had higher specificity than K-TIRADS (50.75%) (P=0.000). Although all the K-TIRADS, ACR-TIRADS and EU-TIRADS have values in risk stratification for thyroid nodules, they cannot simultaneously achieve high sensitivity and high specificity. Further research should be performed to develop a TIRADS which is more suitable for the population of China.

Keywords: Thyroid Imaging Reporting and Data System (TIRADS); Thyroid nodules; ultrasonography (US).