A Multicenter Prospective Validation Study for the Korean Thyroid Imaging Reporting and Data System in Patients with...

Area of Science:

• Radiology
• Oncology
• Endocrinology

Background:

• Thyroid nodules are common, and accurate risk stratification is crucial for appropriate management.
• Existing risk stratification systems may have limitations in predicting malignancy.
• The Korean Thyroid Imaging Reporting and Data System (K-TIRADS) was developed to address these limitations.

Purpose of the Study:

• To prospectively validate the Korean Thyroid Imaging Reporting and Data System (K-TIRADS) for thyroid nodule risk stratification.
• To assess the diagnostic performance of K-TIRADS in predicting malignancy.
• To compare the efficacy of fine-needle aspiration (FNA) guided by K-TIRADS versus a previous system.

Main Methods:

• A prospective study involving 902 thyroid nodules from four institutions between June 2013 and May 2015.
• Analysis of ultrasonography (US) predictors, including nodule solidity and echogenicity.
• Determination of malignancy risk and diagnostic performance for each K-TIRADS category.

Main Results:

• Solid hypoechoic nodules showed significantly higher malignancy risk (p < 0.001).
• K-TIRADS categories 5, 4, 3, and 2 had malignancy risks of 73.4%, 19.0%, 3.5%, and 0.0%, respectively.
• K-TIRADS demonstrated high sensitivity (95.5%) and negative predictive value (96.9%) for malignancy in categories 4 and 5, improving FNA efficacy.

Conclusions:

• The K-TIRADS system, based on solidity and echogenicity, is a valuable tool for thyroid nodule risk stratification.
• K-TIRADS aids in making informed decisions regarding fine-needle aspiration (FNA).
• The findings align with previous retrospective studies, reinforcing the system's reliability.