Diagnostic Accuracy of American College of Radiology Thyroid Imaging Reporting Data System

A Single-Center Cross-sectional Study

Authors

  • Pamela Ann Aribon St. Luke's Medical Center - Global City https://orcid.org/0000-0003-4389-8706
  • Emmylou Teope St. Luke's Medical Center - Global City https://orcid.org/0000-0002-7899-3028
  • Anna Lyn Corneja-Egwolf St. Luke's Medical Center - Global City
  • Maria Patricia Deanna Maningat St. Luke's Medical Center - Global City

Keywords:

ACR-TIRADS, FNAB, thyroid nodules

Abstract

Objective. This study aims to evaluate the diagnostic accuracy of the American College of Radiology Thyroid Imaging Reporting Data System (ACR TI-RADS) in identifying nodules that need to undergo fine-needle aspiration biopsy (FNAB) and identify specific thyroid ultrasound characteristics of nodules associated with thyroid malignancy in Filipinos in a single tertiary center.

Methodology. One hundred seventy-six thyroid nodules from 130 patients who underwent FNAB from January 2018 to December 2018 were included. The sonographic features were described and scored using the ACR TI-RADS risk classification system, and the score was correlated to their final cytopathology results.

Results. The calculated malignancy rates for TI-RADS 2 to TI-RADS 5 were 0%, 3.13%, 7.14%, and 38.23%, respectively, which were within the TI-RADS risk stratification thresholds. The ACR TI-RADS had a sensitivity of 89.5% and specificity of 54%, LR + of 1.95 and LR - of 0.194, NPV of 97.7%, PPV of 19.1%, and accuracy of 58%.

Conclusion. The ACR TI-RADS may provide an effective malignancy risk stratification for thyroid nodules and may help guide the decision for FNAB among Filipino patients. The classification system may decrease the number of unnecessary FNABs for nodules with low-risk scores.

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Author Biography

Pamela Ann Aribon, St. Luke's Medical Center - Global City

Center for Diabetes Thyroid and Endocrine Disorders

References

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. Thyroid. 2016;26(1):1-133. https://pubmed.ncbi.nlm.nih.gov/26462967. https://doi.org/10.1089/thy.2015.0020)

Gao L, Xi X, Jiang Y, et al. Comparison among TIRADS (ACR TI-RADS and KWAK- TI-RADS) and 2015 ATA Guidelines in the diagnostic efficiency of thyroid nodules. Endocrine. 2019;64(1):90-6. https://pubmed.ncbi.nlm.nih.gov/30659427. https://doi.org/10.1007/s12020-019-01843-x.

Carlos-Raboca J, Jimeno CA, Kho SA, et al. The Philippine Thyroid Diseases Study (PhilTiDeS 1): Prevalence of thyroid disorders among adults in the Philippines. J ASEAN Fed Endocr Soc. 2014;27(1):27-33. https://doi.org/10.15605/jafes.027.01.04

Popoveniuc G, Jonklaas J. Thyroid nodules. Med Clin North Am. 2012;96(2):329-49. https://pubmed.ncbi.nlm.nih.gov/22443979. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3575959. https://doi.org/10.1016/j.mcna.2012.02.002.

Cibas ES, Ali SZ; NCI Thyroid FNA State of the Science Conference. The Bethesda system for reporting thyroid cytopathology. Am J Clin Pathol. 2009;132(5):658-65. https://pubmed.ncbi.nlm.nih.gov/19846805. https://doi.org/10.1309/AJCPPHLWMI3JV4LA.

Leenhardt L, Erdogan MF, Hegedus L, et al. 2013 European thyroid association guidelines for cervical ultrasound scan and ultrasound-guided techniques in the postoperative management of patients with thyroid cancer. Eur Thyroid J. 2013;2(3):147-59. https://pubmed.ncbi.nlm.nih.gov/24847448. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4017749. https://doi.org/10.1159/000354537.

Shin JH, Baek JH, Chung J, et al.; Korean Society of Thyroid Radiology (KSThR) and Korean Society of Radiology. Ultrasonography diagnosis and imaging-based management of thyroid nodules: Revised Korean Society of Thyroid Radiology consensus statement and recommendations. Korean J Radiol. 2016;17(3):370-95. https://pubmed.ncbi.nlm.nih.gov/27134526. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4842857. https://doi.org/.10.3348/kjr.2016.17.3.370.

Gharib H, Papini E, Paschke R, et al. AACE/AME/ETA Task Force on Thyroid Nodules. American Association of Clinical Endocrinologists, Associazione Medici Endocrinologi, and European Thyroid Association Medical guidelines for clinical practice for the diagnosis and management of thyroid nodules: Executive summary of recommendations. Endocr Pract. 2010;16(3):468-75. https://pubmed.ncbi.nlm.nih.gov/20551008. https://doi.org/10.4158/EP.16.3.468.

Horvath E, Silva CF, Majlis S, et al. Prospective validation of the ultrasound-based TIRADS (Thyroid Imaging Reporting And Data System) classification: results in surgically resected thyroid nodules. Eur Radiol. 2017; 27(6):2619-28. https://pubmed.ncbi.nlm.nih.gov/27718080. https://doi.org/10.1007/s00330-016-4605-y.

Hoang JK, Middleton WD, Farjat AE, et al. Reduction in thyroid nodule biopsies and improved accuracy with American College of Radiology thyroid imaging reporting and data system. Radiology. 2018;287(1):185-93. https://pubmed.ncbi.nlm.nih.gov/29498593. https://doi.org/10.1148/radiol.2018172572.

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 Am Coll Radiol. 2017;14(5):587-95. https://pubmed.ncbi.nlm.nih.gov/28372962. htpps://doi.org/10.1016/j.jacr.2017.01.046.

Rosario PW, da Silva AL, Nunes MB, Borges MAR. Risk of malignancy in thyroid nodules using the American College of Radiology thyroid imaging reporting and data system in the NIFTP Era. Horm Metab Res. 2018;50(10):735-7. https://pubmed.ncbi.nlm.nih.gov/30312983. https://doi.org/10.1055/a-0743-7326.

Olson E, Wintheiser G, Wolfe KM, Droessler J, Silberstein PT. Epidemiology of thyroid cancer: A review of the National Cancer database, 2000-2013. Cureus. 2019;11(2):e4127. https://pubmed.ncbi.nlm.nih.gov/31049276. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6483114. https://doi.org/10.7759/cureus.4127.

Zheng Y, Xu S, Kang H, Zhan W. A single-center retrospective validation study of the American College of Radiology thyroid imaging reporting and data system. Ultrasound Q. 2018;34(2):77-83. https://pubmed.ncbi.nlm.nih.gov/29596298. https://doi.org/10.1097/RUQ.0000000000000350.

Kwak JY, Han KH, Yoon JH, et al. Thyroid imaging reporting and data system for US features of nodules: A step in establishing better stratification of cancer risk. Radiology. 2011;260(3):892-9. https://pubmed.ncbi.nlm.nih.gov/21771959. https://doi.org/10.1148/radiol.11110206.

Grant E, Tessler F, Hoang J, et al. Thyroid ultrasound reporting lexicon: white paper of the ACR Thyroid Imaging, Reporting and Data System (TIRADS) Committee. J Am Coll Radiol. 2015;12(12 Pt A):1272-9. https://pubmed.ncbi.nlm.nih.gov/26419308. https://doi.org/10.1016/j.jacr.2015.07.011.

Dy JG, Kasala R, Yao C, Ongoco R, Mojica DJ. Thyroid Imaging Reporting and Data System (TIRADS) in stratifying risk of thyroid malignancy at The Medical City. J ASEAN Fed Endocr Soc. 2017;32(2):108-16. https://pubmed.ncbi.nlm.nih.gov/33442093. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7784109. https://doi.org/10.15605/jafes.032.02.03.

Moon WJ, Jung SL, Lee JH, et al.; Thyroid Study Group, Korean Society of Neuro- and Head and Neck Radiology. Benign and malignant thyroid nodules: US differentiation - multicenter retrospective study. Radiology. 2008;247(3):762-70. https://pubmed.ncbi.nlm.nih.gov/18403624. https://doi.org/10.1148/radiol.2473070944.

Papini E, Guglielmi R, Bianchini A, et al. Risk of malignancy in nonpalpable thyroid nodules: Predictive value of ultrasound and color-Doppler features. J Clin Endocrinol Metab. 2002;87(5):1941-6. https://pubmed.ncbi.nlm.nih.gov/11994321. https://doi.org/10.1210/jcem.87.5.8504.

Macedo BM, Izquierdo RF, Golbert L, Meyer ELS. Reliability of Thyroid Reporting and Data System (TI-RADS), and ultrasonographic classification of the American Thyroid Association (ATA) in differentiating benign from malignant thyroid nodules. Arch Endocrinol Metab. 2018;62(2):131-8. https://pubmed.ncbi.nlm.nih.gov/29641731. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10118978. https://doi.org/10.20945/2359-3997000000018.

Puno-Ramos MPG, Villa ML, Kasala RG, Arzadon J, Alcazaren EAS. Ultrasound features of thyroid nodules predictive of thyroid malignancy as determined by fine needle aspiration biopsy. Philipp J Intern Med. 2015;53(2):1-8.

Cañete EJ, Sison-Peña CM, Jimeno CA. Clinicopathological, biochemical, and sonographic features of thyroid nodule predictive of malignancy among adult Filipino patients in a tertiary hospital in the Philippines. Endocrinol Metab (Seoul). 2014;29(4):489-97. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4285043. https://doi.org/10.3803/EnM.2014.29.4.489.

Middleton WD, Teefey SA, Reading CC, et al., Multi-institutional analysis of thyroid nodule risk stratification using the American College of Radiology Thyroid imaging reporting and data system. AJR Am J Roentgenol. 2017;208(6):1331-41. https://pubmed.ncbi.nlm.nih.gov/28402167. https://doi.org/10.2214/AJR.16.17613.

Ito Y, Miyauchi A, Inoue H, et al. An observational trial for papillary thyroid microcarcinoma in Japanese patients. World J Surg. 2010;34(1):28-35. https://pubmed.ncbi.nlm.nih.gov/20020290. htttps://doi.org/10.1007/s00268-009-0303-0.

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Published

2024-01-08

How to Cite

Aribon, P. A., Teope, E., Corneja-Egwolf, A. L., & Maningat, M. P. D. (2024). Diagnostic Accuracy of American College of Radiology Thyroid Imaging Reporting Data System: A Single-Center Cross-sectional Study. Journal of the ASEAN Federation of Endocrine Societies. Retrieved from https://www.asean-endocrinejournal.org/index.php/JAFES/article/view/2657

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