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Diagnostic Performance of the Modified Korean Thyroid Imaging Reporting and Data System for Thyroid Malignancy: A

Sae Rom Chung¹, Hye Shin Ahn², Young Jun Choi¹

¹Department of Radiology and Research Institute of Radiology, Asian Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

Korean Journal of Radiology

|June 16, 2021

Summary

Modified Korean Thyroid Imaging Reporting and Data System (K-TIRADS) versions reduce unnecessary biopsies for small thyroid nodules while maintaining high malignancy detection sensitivity for larger nodules.

Keywords:

Diagnostic performance Fine-needle aspiration Thyroid cancer Thyroid nodule Ultrasonography

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Area of Science:

Radiology
Oncology
Medical Imaging

Background:

Thyroid nodules are common, requiring accurate diagnostic tools.
The Korean Thyroid Imaging Reporting and Data System (K-TIRADS) aids in classifying thyroid nodules.
Optimizing K-TIRADS can improve diagnostic accuracy and reduce unnecessary procedures.

Purpose of the Study:

To evaluate the diagnostic performance of modified K-TIRADS versions.
To compare these modified systems against the 2016 K-TIRADS for thyroid nodule evaluation.
To assess the impact on malignancy detection and unnecessary biopsy rates.

Main Methods:

Retrospective analysis of 5708 thyroid nodules (≥ 1.0 cm) from 5081 patients.
Evaluation of multiple modified K-TIRADS versions with varying biopsy size thresholds.
Comparison of diagnostic sensitivity, specificity, and unnecessary biopsy rates with the 2016 K-TIRADS.

Main Results:

Modified K-TIRADS versions demonstrated reduced unnecessary biopsy rates for small nodules (1-2 cm) by 19.2-32.8%.
Sensitivity for malignancy in large nodules (> 2 cm) remained high (98%) across modified K-TIRADS versions.
Specificity improved with modified K-TIRADS, ranging from 39.7% to 50.2% compared to 24.4% for 2016 K-TIRADS.

Conclusions:

Modified K-TIRADS versions effectively decrease unnecessary biopsies for small thyroid nodules.
These updated systems maintain high sensitivity for detecting malignancy in larger nodules.
The modified K-TIRADS offers improved specificity and reduced unnecessary procedures in thyroid nodule assessment.