Thyroid Imaging Reporting and Data System Risk Stratification of Thyroid Nodules: Categorization Based on Solidity...

Area of Science:

• Radiology
• Oncology
• Medical Imaging

Background:

• Ultrasonography (US) is crucial for assessing thyroid nodule malignancy risk.
• A standardized risk-stratification system for thyroid nodules is currently lacking.
• This study aimed to develop a clinically applicable US-based risk-stratification system.

Purpose of the Study:

• To develop the Thyroid Imaging Reporting and Data System (TIRADS) for thyroid nodules.
• To primarily utilize nodule solidity and echogenicity for risk stratification.
• To create a feasible system for clinical use.

Main Methods:

• Analyzed 2000 thyroid nodules (≥ 1 cm) with final diagnoses from diverse institutions.
• Investigated the predictive value of US features within solidity and echogenicity categories.
• Integrated US predictors to categorize malignancy risk.

Main Results:

• Suspicious US features (microcalcification, taller-than-wide, spiculated margins) predict malignancy in solid/hypoechoic nodules.
• Microcalcification is key in partially cystic nodules; microcalcification and spiculated margins in iso-/hyperechoic nodules.
• Malignancy risk varied based on nodule composition and suspicious features, leading to five TIRADS categories.

Conclusions:

• TIRADS effectively stratifies thyroid nodule malignancy risk using US patterns (solidity, echogenicity, suspicious features).
• The proposed TIRADS system, based on US findings, will enhance risk assessment and management decisions for thyroid nodules.