Department of Medical imaging and nuclear medicine, Medical College of Nanchang University, Nanchang, Nanchang, Jiangxi, China.
Department of Ultrasonic medicine, The first affiliated hospital of gannan medical university, Ganzhou, Jiangxi, China.
Clinics (Sao Paulo). 2021 Jan 20;76:e2126. doi: 10.6061/clinics/2021/e2126. eCollection 2021.
In our organization, it has been necessary in our organization to calculate the risk categories according to the American Thyroid Association (ATA), the American Association of Clinical Endocrinologists/American College of Endocrinology/Associazione Medici Endocrinologi (AACE/ACE/AME), and the American College of Radiology Thyroid Imaging Reporting and Data System (ACR TIRADS) classification systems for each patient, from the year 2019; these are also required to be registered in the database. This creates a barrier to medical collaboration in everyday radiological practice because using multiple rating systems can be confusing for both readers and patients. For the change in routine practice, this study aimed to compare diagnostic parameters of the ATA, AACE/ACE/AME, and ACR TIRADS classification systems for the detection of suspicious thyroid nodule(s) considering the results of fine-needle aspiration cytopathology as the reference standard.
Data on ultrasound characteristics (2,000 nodules) and fine-needle aspiration cytopathology (39 nodules) were included in the analysis. The decision making of fine-needle aspiration biopsies was evaluated from the ultrasound characteristics as per the ATA, AACE/ACE/AME, and ACR TIRADS classification systems.
The ATA, AACE/ACE/AME, and ACR TIRADS recommended 26, 32, and 37 nodules for fine-needle aspiration biopsies, respectively. Considering the results of fine-needle aspiration cytopathology as the reference standard, the ATA, AACE/ACE/AME, and ACR TIRADS classification systems had 0.993, 0.996, and 0.998 sensitivity, respectively. The accuracies were 0.641, 0.795, and 0.923, respectively.
The ACR TIRADS classification system is less invasive and can identify suspicious nodules more accurately than that of ATA and AACE/ACE/AME.
自 2019 年起，我们组织有必要根据美国甲状腺协会（ATA）、美国临床内分泌医师协会/美国内分泌学会/意大利内分泌学会（AACE/ACE/AME）以及美国放射学会甲状腺影像报告和数据系统（ACR TIRADS）分类系统为每位患者计算风险类别，并且这些都需要在数据库中注册。这在日常放射实践中对医学协作造成了障碍，因为使用多个评分系统可能会使读者和患者感到困惑。为了改变常规实践，本研究旨在比较 ATA、AACE/ACE/AME 和 ACR TIRADS 分类系统在检测可疑甲状腺结节时的诊断参数，以细针抽吸细胞学病理结果为参考标准。
分析了超声特征（2000 个结节）和细针抽吸细胞学（39 个结节）的数据。根据 ATA、AACE/ACE/AME 和 ACR TIRADS 分类系统的超声特征评估细针抽吸活检的决策。
ATA、AACE/ACE/AME 和 ACR TIRADS 分别推荐对 26、32 和 37 个结节进行细针抽吸活检。以细针抽吸细胞学病理结果为参考标准，ATA、AACE/ACE/AME 和 ACR TIRADS 分类系统的敏感性分别为 0.993、0.996 和 0.998。准确性分别为 0.641、0.795 和 0.923。
与 ATA 和 AACE/ACE/AME 相比，ACR TIRADS 分类系统的侵袭性更小，能够更准确地识别可疑结节。
