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Published on: May 23, 2015
Nodule size significantly affects the diagnostic value of chinese thyroid imaging reporting and data system: a
Hu Huang1, Qi Gao2, Hong-Jian Li3
1Department of Thyroid and Breast Surgery, Affiliated Hospital of Jiangnan University, Wuxi, People's Republic of China.
Purpose:
This study aimed to investigate the influence of thyroid nodule size on the diagnostic efficacy of the Chinese thyroid imaging reporting and data system (C-TIRADS).
Patients And Methods:
This retrospective study included pathologically confirmed thyroid nodules categorized into ≤ 10 mm and > 10 mm groups. The ultrasound characteristics of these nodules were evaluated, and C-TIRADS scoring and classification were performed. Receiver operating characteristic (ROC) curves were generated to ascertain optimal threshold values for scoring and classification in both groups. Subsequently, the diagnostic accuracies of C-TIRADS for thyroid nodules in the two groups were compared.
Results:
The ≤ 10 mm group included 237 benign, 1 low-risk, and 1,376 malignant nodules. The > 10 mm group included 499 benign, 13 low-risk, and 349 malignant nodules. The Mann-Whitney U test results revealed that scores for malignant thyroid nodules were significantly ˃ those for benign nodules in both groups. The ROC curves (AUC) for C-TIRADS scoring and classification in the ≤ 10 mm group were 0.707 and 0.684, respectively, with optimal threshold values of > 2 points and > C-TR 4B. In the > 10 mm group, AUCs for C-TIRADS scoring and classification were 0.927 and 0.922, respectively, with optimal threshold values of > 1 point and > C-TR of 4A. The > 10 mm group had greater specificity, negative predictive value (NPV) and accuracy than the ≤ 10 mm group, whereas the > 10 mm group had lower positive predictive value (PPV) than the ≤ 10 mm group at these optimal thresholds (all P-values < 0.001).
Conclusion:
The diagnostic performance of C-TIRADS scoring and classification was significantly lower for thyroid nodules with a diameter of ≤ 10 mm than for those with a diameter of > 10 mm.
