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Updated: Oct 31, 2025
A Swin Transformer-Based Model for Thyroid Nodule Detection in Ultrasound Images
Published on: April 21, 2023
Comparing ultrasound assessment of thyroid nodules using BTA U classification and ACR TIRADS measured against
Simon McClean1, Eugene Omakobia2, R James A England3
1Hull York Medical School, Hull University Teaching Hospitals NHS Trust.
Introduction:
The British Thyroid Association (BTA) recommends ultrasound assessment of thyroid nodules using the U classification. The American College of Radiologists (ACR) recommend assessment with the Thyroid Imaging Reporting and Data System (TIRADS). We conduct the first UK study to compare these two systems.
Methods:
Ultrasound (US) reports of patients who underwent surgical excision of thyroid nodules over a 10-year period in one UK centre were reviewed. US findings were collected, and the classifications were retrospectively applied. The systems were compared to histopathological diagnosis.
Results:
308 nodules in 296 patients are included. 135 nodules (43.8%) were malignant. U classification showed sensitivity of 88.1% in recommending FNA, significantly higher than TIRADS at 73.3% (p = .0002). The U classification showed specificity of 41.6%, significantly lower than TIRADS at 64.2% (p=<0.0001). PPV between classifications at equivalent levels showed no significant difference at U3/TR-3 (p=.81), U4/TR-4 (p=.30) or U5/TR-5 (p=.90).
Discussion:
Classification systems enable risk stratification of potentially malignant thyroid nodules. This study shows BTA U classification has a higher sensitivity but lower specificity than TIRADS.
