Journal of Endocrinology and Metabolism, ISSN 1923-2861 print, 1923-287X online, Open Access |
Article copyright, the authors; Journal compilation copyright, J Endocrinol Metab and Elmer Press Inc |
Journal website https://www.jofem.org |
Original Article
Volume 11, Number 3-4, August 2021, pages 69-75
Diagnostic Performance of ACR-TIRADS in Differentiating Benign From Malignant Thyroid Nodules in Patients Undergoing Fine-Needle Aspiration Biopsy: Comparative Study Based on Five International Guidelines for Management of Thyroid Nodules
Figure
Tables
Benign, N (%) | Malignant, N (%) | Risk of malignancy (%) | Test of significance | |
---|---|---|---|---|
Texture | ||||
Spongiform | 18 (9) | 0 (0) | 0 | Chi-square P = 0.0376 |
Mixed | 90 (45) | 10 (5) | 10 | |
Solid | 66 (33) | 16 (8) | 19.51 | |
Echogenicity | ||||
Hyperechoic | 2 (1) | 0 (0) | 0 | Chi-square P = 0.5827 |
Hypoechoic | 172 (86) | 26 (13) | 13.13 | |
Echogenic foci | ||||
None or comet tail | 140 (70) | 16 (8) | 10.26 | Chi-square P = 0.0109 |
Macro | 8 (4) | 0 (0) | 0 | |
Peripheral | 2 (1) | 2 (1) | 50 | |
Punctate | 24 (12) | 8 (4) | 25 | |
Orientation | ||||
Wide | 168 (84) | 26 (13) | 13.4 | Chi-square P = 0.3364 Two-sided probability P ≤ 1.000 |
Tall | 6 (3) | 0 (0) | 0 | |
Peripheral halo | ||||
Absent | 170 (65) | 22 (11) | 11.5 | Chi-square P < 0.0015 Two-sided probability P ≤ 0.0111 |
Present | 4 (2) | 4 (2) | 50 |
Benign, n (%) | Malignant, n (%) | Risk of malignancy (%) | Test of significance | |
---|---|---|---|---|
ACR-TIRADS: American College of Radiology Thyroid Imaging Reporting and Data System; ATA: American Thyroid Association; EU-TIRADS: European Thyroid Imaging and Reporting Data System; KSThR: Korean Society of Thyroid Radiology; K-TIRADS: Kwak-TIRADS. | ||||
ACR-TIRADS | ||||
TR 2 - Non-suspicious | 14 (7) | 0 (0) | 0 | Chi-square P = 0.0001 |
TR 3 - Mildly suspicious | 62 (31) | 2 (1) | 3.1 | |
TR 4 - moderately suspicious | 84 (42) | 14 (7) | 14.3 | |
TR 5 - Highly suspicious | 14 (7) | 10 (5) | 41.7 | |
ATA | ||||
TR 2 - Very low | 54 (27) | 0 (0) | 0 | Chi-square P = 0.0001 |
TR 3 - Low | 52 (26) | 2 (1) | 3.7 | |
TR 4 - Intermediate | 40 (20) | 6 (3) | 13.0 | |
TR 5 - High | 28 (14) | 18 (9) | 39.1 | |
EU-TIRADS | ||||
Benign | 14 (7) | 0 (0) | 0 | Chi-square P = 0.0001 |
Low | 2 (1) | 0 (0) | 0 | |
Intermediate | 120 (60) | 8 (4) | 6.3 | |
High | 38 (19) | 18 (9) | 32.1 | |
K-TIRADS | ||||
3 - Probably benign | 14 (7) | 0 (0) | 0 | Chi-square P = 0.0001 |
4a - Low suspicion | 68 (34) | 2 (1) | 2.9 | |
4b - Intermediate suspicion | 82 (41) | 12 (6) | 12.8 | |
4c - Moderate suspicion | 10 (5) | 12 (6) | 54.5 | |
KSThR | ||||
TR 2 - Very low | 14 (7) | 0 (0) | 0 | Chi-square P = 0.0001 |
TR 3 - Low | 2 (1) | 0 (0) | 0 | |
TR 4 - Intermediate | 130 (65) | 12 (6) | 8.5 | |
TR 5 - High | 28 (14) | 14 (7) | 33.3 | |
Total | 174 (87) | 26 (13) |
Sensitivity, % (95% confidence limit) | Specificity, % (95% confidence limit) | PPV, % (95% confidence limit) | NPV, % (95% confidence limit) | Area under curve (ROC) (95% confidence limit) | False negative, N (%) | Unnecessary FNA rate, N (%) | |
---|---|---|---|---|---|---|---|
ACR-TIRADS: American College of Radiology Thyroid Imaging Reporting and Data System; ATA: American Thyroid Association; EU-TIRADS: European Thyroid Imaging and Reporting Data System; KSThR: Korean Society of Thyroid Radiology; K-TIRADS: Kwak-TIRADS; PPV: positive predictive value; NPV: negative predictive value; ROC: receiver operating curves; FNA: fine-needle aspiration. | |||||||
ACR-TIRADS | 92.31 (75 - 99) | 40.23 (32 - 47) | 18.75 (0.12 - 0.26) | 97.22 (0.90 - 0.99) | 0.6627 (0.59 - 0.72) | 2 (1) | 104 (52) (P = 0.0013) |
K-TIRADS | 96.15 (80 - 99) | 8.05 (4 - 13) | 13.51 (0.08 - 0.19) | 93.33 (0.68 - 0.99) | 0.5210 (0.47 - 0.56) | 1 (0.5) | 160 (80) (P = 0.4482) |
KSThR | 84.62 (65 - 95) | 13.79 (9 - 19) | 12.79 (0.08 - 0.18) | 85.71 (0.67 - 0.95) | 0.5080 (0.43 - 0.58) | 4 (2) | 150 (75) (P = 0.8273) |
EU-TIRADS | 76.92 (56 - 91) | 36.78 (29 - 44) | 15.38 (0.09 - 0.22) | 91.43 (0.82 - 0.96) | 0.5685 (0.47 - 0.65) | 6 (3) | 110 (55) (P = 0.1718) |
ATA | 92.31 (74 - 99) | 34.48 (27 - 42) | 17.39 (0.11 - 0.24) | 96.77 (0.89 - 0.99) | 0.6340 (0.57 - 0.69) | 2 (1) | 114 (57) (P = 0.0059) |
Suspicious | Low risk | High risk | |
---|---|---|---|
ACR-TIRADS: American College of Radiology Thyroid Imaging Reporting and Data System; ATA: American Thyroid Association; EU-TIRADS: European Thyroid Imaging and Reporting Data System; KSThR: Korean Society of Thyroid Radiology; K-TIRADS: Kwak-TIRADS. | |||
ACR-TIRADS | 1 cm | 2.5 cm | |
EU-TIRADS | 1 cm | 2 cm | |
KSThR | 1 cm | 1.5 cm | |
K-TIRADS | 1 cm | 2 cm | 0.5 cm |
ATA | 1 cm | 2 cm | 0.5 cm |