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Updated: Jan 7, 2026
A Swin Transformer-Based Model for Thyroid Nodule Detection in Ultrasound Images
Published on: April 21, 2023
The Diagnostic Performance and Interobserver Consistency of Contrast-enhanced Ultrasound Thyroid Imaging Reporting
Xin Ye1, Ya-Qing Zhang1, Long-Hui Zhang2
1Department of Ultrasound, Zhongshan Hospital, Institute of Ultrasound in Medicine and Engineering, Fudan University, Shanghai, China; Shanghai Institute of Medical Imaging, Shanghai, China.
Objective:
This study aimed to evaluate the diagnostic performance and inter-observer consistency of contrast-enhanced ultrasound (CEUS) Thyroid Imaging Reporting and Data System (TI-RADS) for the risk stratification of thyroid nodules.
Methods:
This study retrospectively included consecutive patients with thyroid nodules who underwent non-enhanced US and CEUS examinations from three medical centers between January 2022 and August 2022. Four readers evaluated the US features of these thyroid nodules and classified them according to the American College of Radiology (ACR) TI-RADS and CEUS TI-RADS. The diagnostic performance of CEUS TI-RADS and the unnecessary fine needle aspiration biopsy rate were assessed and compared with ACR TI-RADS. Intra-class correlation coefficients were used for assessing the multi-reader consistency.
Results:
A total of 483 patients (mean age, 46.8 ± 12.8 years; 354 females) with 515 pathology-proven thyroid nodules (315 malignant) were included. CEUS TI-RADS had better diagnostic accuracy (85.6%-88.5% vs. 77.5%-84.5%, p<0.05) and specificity (68.0%-78.0% vs. 45.5%-62.5%, p<0.05), while obtaining a similar sensitivity as ACR TI-RADS (95.2%-97.1% vs. 97.8%-98.4%, p>0.05). The unnecessary biopsy rate of CEUS TI-RADS was lower than that of ACR TI-RADS (27.8% vs. 35.5%, p<0.05) for 1 cm or larger nodules. Excellent inter-reader consistency was gained in the assessment of the CEUS TI-RADS categories (with an intra-class correlation coefficient of 0.896). Meanwhile, moderate to good inter-reader consistency was obtained in the assessment of the CEUS features (with intra-class correlation coefficients ranging from 0.500 to 0.846).
Conclusion:
With satisfactory inter-reader consistency, the CEUS TI-RADS criteria significantly improved diagnostic performance and fine needle aspiration biopsy recommendations for thyroid nodules.
