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Journal of Peking University(Health Sciences) ›› 2019, Vol. 51 ›› Issue (6): 1067-1070. doi: 10.19723/j.issn.1671-167X.2019.06.016

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Applicational value of 2017 ACR TI-RADS stratification in diagnosing thyroid nodules

Peng FU,Wen CHEN(),Li-gang CUI,Hui-yu GE,Shu-min WANG   

  1. Department of Ultrasound, Peking University Third Hospital, Beijing 100191, China
  • Received:2019-03-20 Online:2019-12-18 Published:2019-12-19
  • Contact: Wen CHEN E-mail:wendy7989@sina.com
  • Supported by:
    Supported by the National Natural Science Foundation of China(81771842)

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Abstract:

Objective: To summarize and evaluate the value of applying the thyroid imaging reporting and data system (TI-RADS) released by American College of Radiology (ACR) in 2017 of the thyroid classification, and to propose an optimized classification method based on the result to facilitate more accurate and precise risk stratification of thyroid nodules.Methods: In the study, 342 thyroid nodules assessed by 2017 ACR TI-RADS were retrospectively analyzed. Each nodule had a score, and all the scores of nodules were compared with the pathological results. The proportion of malignant nodules in different scoring ranges was obtained. The diagnostic efficacy of all nodules,nodules above 1 cm and less than or equal to 1 cm was evaluated by ROC curve, respectively.Results: The AUC of all nodules, nodules above 1 cm and less than or equal to 1 cm were 0.907, 0.936 and 0.717, respectively. With the increase of the scores, the proportion of benign nodules decreased gradually, and the proportion of malignant nodules increased, especially nodules of 4-6 scores increased significantly. Based on the proportion of malignant nodules with 3 scores, the proportion of malignant nodules with 4, 5 and 6 scores increased 1.6, 3.8 and 5.3 times, respectively. The proportion of malignant nodules with 6-8 scores was 81%-84%, while the proportion of malignant nodules with 9 scores or more was 93%-94%. According to the distribution characteristics of malignant nodules, the classification of TI-RADS was adjusted. TI-RADS 4 was divided into TI-RADS 4a, TI-RADS 4b and TI-RADS 4c, corresponding to 4, 5 and 6-8 scores respectively, while the nodules with 9 scores or more were divided into TI-RADS 5.Conclusion: 2017 ACR TI-RADS has high diagnostic value for thyroid nodules above 1 cm, but it is not so effective for the nodules less than or equal to 1 cm. According to the proportion distribution of malignant nodules in diffe-rent scoring ranges, appropriate adjustment of classification will be more accurate and precisely predict the malignant risk of nodules.

Key words: Thyroid nodule, Ultrasonography, Diagnosis, differential, Pathology, Thyroid Imaging Reporting and Data System

CLC Number: 

  • R736.1

Figure 1

Distribution of nodules corresponding to different scores"

Figure 2

Percentage of malignant nodules corresponding to different scores"

Table 1

Distribution of benign and malignant nodules according to the 2017 ACR TI-RADS"

Figure 3

ROC curve for predicting benign and malignant efficiency of nodules by score value A, all nodules (n=342); B, nodules >1 cm (n=227); C, nodules ≤1 cm (n=115)."

[1] Tessler FN, Middleton WD, Grant EG , et al. ACR thyroid imaging, reporting and data system (TI-RADS): White paper of the ACR TI-RADS Committee[J]. J Am Coll Radiol, 2017,14(5):587-595.
[2] Grant EG, Tessler FN, Hoang JK , et al. Thyroid ultrasound reporting lexicon: white paper of the ACR Thyroid Imaging, Reporting and Data System (TIRADS) Committee[J]. J Am Coll Ra-diol, 2015,12(12):1272-1279.
[3] Gharib H, Papini E, Garber JR , et al. AACE/AME Guidelines American Association of Clinical Endocrinologists and Associazione Medici Endocrinologi medical guidelines for clinical practice for the diagnosis and management of thyroid nodules: 2016 update[J]. Endocr Pract, 2016,22(5):622-639.
[4] Middleton WD, Teefey SA, Reading CC , et al. Multiinstitutional analysis of thyroid nodule risk stratification using the American College of Radiology Thyroid Imaging Reporting and Data System[J]. AJR Am J Roentgenol, 2017,208(6):1331-1341.
[5] Kumbhar SS, O’Malley RB, Robinson TJ, et al. Why thyroid surgeons are frustrated with radiologists: Lessons learned from pre-and postoperative US[J]. Radiographics, 2016,36(7):150-250.
[6] Gunderman RB, Mcneive LR . Is structured reporting the answer?[J]. Radiology, 2014,273(1):7-9.
[7] Haugen BR, Alexander EK, Bible KC , et al. 2015 American Thyroid Association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: the American Thyroid Association guidelines task force on thyroid nodules and differentiated thyroid cancer[J]. Thyroid, 2016,26(1):1-133.
[8] Haddad RI, Lydiatt WM, Ball DW , et al. Anaplastic Thyroid Carcinoma, Version 2.2015[J]. J Natl Compr Canc Netw, 2015,13(9):1140-1150.
[9] Wémeau JL, Sadoul JL, d’Herbomez M, et al. Guidelines of the French Society of Endocrinology for the management of thyroid nodules[J]. Ann Endocrinol (Paris), 2011,72(4):251-281.
[10] Shin JH, Baek JH, Chung J , et al. Ultrasonography diagnosis and imaging-based management of thyroid nodules: Revised Korean Society of Thyroid Radiology consensus statement and recommendations[J]. Korean J Radiol, 2016,17(3):370-395.
[11] 刘红, 胡正明, 罗海愉 , 等. ACR TI-RADS分类在诊断甲状腺结节中的应用价值探究[J]. 中国超声医学杂志, 2018,34(8):673-675.
[12] 钟敏莹, 石小红, 杨丽丽 , 等. TI-RADS分类系统对不同直径甲状腺结节的诊断价值[J]. 中国超声医学杂志, 2016,32(4):289-291.
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