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Prospective validation of the ultrasound based TIRADS (Thyroid Imaging Reporting And Data System) classification: results in surgically resected thyroid nodules.

Abstract：

OBJECTIVE:To assess performance of TIRADS classification on a prospective surgical cohort, demonstrating its clinical usefulness. METHODS:Between June 2009 and October 2012, patients assessed with pre-operative ultrasound (US) were included in this IRB-approved study. Nodules were categorised according to our previously described TIRADS classification. Final pathological diagnosis was obtained from the thyroidectomy specimen. Sensitivity, specificity, positive/negative predictive values and likelihood ratios were calculated. RESULTS:The study included 210 patients with 502 nodules (average: 2.39 (±1.64) nodules/patient). Median size was 7 mm (3-60 mm). Malignancy was 0 % (0/116) in TIRADS 2, 1.79 % (1/56) in TIRADS 3, 76.13 % (185/243) in TIRADS 4 [subgroups: TIRADS 4A 5.88 % (1/17), TIRADS 4B 62.82 % (49/78), TIRADS 4C 91.22 % (135/148)], and 98.85 % (86/87) in TIRADS 5. With a cut-off point at TIRADS 4-5 to perform FNAB, we obtained: sensitivity 99.6 % (95 % CI: 98.9-100.0), specificity 74.35 % (95 % CI: 68.7-80.0), PPV 82.1 % (95 % CI: 78.0-86.3), NPV 99.4 % (95 % CI: 98.3-100.0), PLR 3.9 (95 % CI: 3.6-4.2) and an NLR 0.005 (95 % CI: 0.003-0.04) for malignancy. CONCLUSION:US-based TIRADS classification allows selection of nodules requiring FNAB and recognition of those with a low malignancy risk. KEY POINTS:• TIRADS classification allows accurate selection of thyroid nodules requiring biopsy (TIRADS 4-5). • The recognition of benign/possibly benign patterns can avoid unnecessary procedures. • This classification and its sonographic patterns are validated using surgical specimens.

journal_name

Eur Radiol

journal_title

European radiology

authors

Horvath E,Silva CF,Majlis S,Rodriguez I,Skoknic V,Castro A,Rojas H,Niedmann JP,Madrid A,Capdeville F,Whittle C,Rossi R,Domínguez M,Tala H

doi

10.1007/s00330-016-4605-y

subject

Has Abstract

pub_date

2017-06-01 00:00:00

pages

2619-2628

issue

eissn

0938-7994

issn

1432-1084

pii

10.1007/s00330-016-4605-y

journal_volume

pub_type

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Prospective validation of the ultrasound based TIRADS (Thyroid Imaging Reporting And Data System) classification: results in surgically resected thyroid nodules.