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Similarities and Differences Between Thyroid Imaging Reporting and Data Systems.

So Jin Yoon1,2,3,4, Dong Gyu Na1,2,3,4, Hye Yun Gwon1,2,3,4

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AJR. American Journal of Roentgenology
|March 28, 2019
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Summary
This summary is machine-generated.

Comparing Korean, American (ACR), and European TI-RADS for thyroid nodules reveals similarities in ultrasound lexicons but significant differences in nodule categorization and fine-needle aspiration (FNA) performance for malignancy detection.

Keywords:
TI-RADSTIRADSimagingreporting systemsthyroid

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Area of Science:

  • Radiology
  • Endocrinology
  • Oncology

Background:

  • Thyroid nodules are common, and accurate risk stratification is crucial for appropriate management.
  • Standardized reporting systems like Thyroid Imaging Reporting and Data System (TIRADS) aim to improve consistency in ultrasound interpretation and fine-needle aspiration (FNA) referral.
  • Multiple international TIRADS guidelines exist, including Korean, American College of Radiology (ACR), and European versions, necessitating comparative analysis.

Purpose of the Study:

  • To identify similarities and differences among Korean TIRADS, ACR TI-RADS, and European TIRADS.
  • To compare the diagnostic performance of sonographic FNA criteria for detecting malignant thyroid nodules across these three systems.

Main Methods:

  • Retrospective review of 2274 thyroid nodules (≥1 cm) from 1836 patients diagnosed between January 2011 and December 2016.
  • Nodules were classified according to Korean TIRADS, ACR TI-RADS, and European TIRADS guidelines.
  • Comparison of ultrasound (US) lexicons, categorized risk levels, and diagnostic performance of FNA criteria for malignancy.

Main Results:

  • Most US lexicons were similar across the three systems, with a notable exception in the European TIRADS definition of mixed echogenicity.
  • Strong correlations were found between categorized nodule risks (r = 0.777-0.877, p < 0.001) across systems.
  • Significant differences were observed in nodule categorization (categories 5, 4, 3; p < 0.001) and in the sensitivity, specificity, and unnecessary FNA rates of FNA criteria for malignancy (p < 0.001).

Conclusions:

  • While Korean TIRADS, ACR TI-RADS, and European TIRADS share common ultrasound terminology, significant variations exist in nodule classification.
  • These differences impact the diagnostic performance of FNA criteria, affecting malignancy detection rates and the likelihood of unnecessary procedures.
  • Further research is needed to harmonize TIRADS guidelines for improved consistency and diagnostic accuracy in thyroid nodule evaluation.