六种不同的甲状腺影像报告和数据系统（TI-RADS）指南（包括美国放射学会（ACR）/夸克（Kwak）/韩国（K）/欧洲（EU）/美国甲状腺协会（ATA）/中国（C）-TI-RADS）诊断性能的真实世界比较
A real-world comparison of the diagnostic performances of six different TI-RADS guidelines, including ACR-/Kwak-/K-/EU-/ATA-/C-TIRADS.
作者信息
Topcuoglu Osman Melih, Uzunoglu Betul, Orhan Tolga, Basaran Ekin Bora, Gormez Ayşegul, Sarica Ozgur
机构信息
Yeditepe University Hospitals, Department of Radiology, Kosuyolu 34718, Istanbul, Turkey.
Yeditepe University Hospitals, Department of Radiology, Kosuyolu 34718, Istanbul, Turkey.
出版信息
Clin Imaging. 2025 Jan;117:110366. doi: 10.1016/j.clinimag.2024.110366. Epub 2024 Nov 22.
PURPOSE
To compare the diagnostic performance of six different currently available guidelines including the American College of Radiology Thyroid Imaging and Reporting Data System (ACR-TIRADS), Kwak-TIRADS, Korean TIRADS (K-TIRADS), European TIRADS (EU-TIRADS), American Thyroid Association (ATA) and Chinese TIRADS (C-TIRADS), in differentiating malignant from benign thyroid nodules (TN).
MATERIALS AND METHODS
In this single-center study, between January-2007 and September-2023, ultrasound (US) images of TNs that were pathologically proven either by surgery or by fine needle aspiration biopsy (FNAB), were retrospectively evaluated and categorized according to six different currently available guidelines. Area under curve (AUC), sensitivity, specificity, positive and negative predictive values (PPV and NPV, respectively) and miss rates for malignancy (MRM) were calculated for each guideline.
RESULTS
A total of 829 TNs (n = 234 malignant and n = 595 benign) were included. AUC, sensitivity, specificity, PPV, NPV and accuracy for ACR-TIRADS were 0.786, 99.8 %, 27.1 %, 31.92 %, 99.73 % and 54.6 %, respectively; for Kwak-TIRADS 0.839, 97.8 %, 42.1 %, 36.29 %, 98.11 % and 63.1 %, respectively; for K-TIRADS 0.797, 97.6 %, 41.6 %, 36.01 %, 84.85 % and 62.8, respectively, for EU-TIRADS 0.766, 97.8 %, 35.6 %, 33.89 %, 97.92 % and 59.1 %, respectively, for ATA 0.788, 97.5 %, 49.8 %, 32.86 %, 88.16 % and 64.2 %, respectively and for C-TIRADS 0.842, 0 %, 92.8 %, 54.3 %, 39.53 %, 90.42 %, and 68.8 % respectively. MRM regarding ACR-/Kwak-/K-/EU-/ATA-/C-TIRADS were 2.2 %, 0.5 %, 2.9 %, 2.5 %, 3.3 % and 0.1 %, respectively.
CONCLUSION
Six different currently available TIRADS guidelines can provide effective differentiation of malignant TNs from benign ones with similar diagnostic performances. However; C-TIRADS offered the highest AUC and the lowest MRM than the other guidelines, in this series.
目的
比较六种不同的现有指南，即美国放射学会甲状腺影像报告和数据系统（ACR-TIRADS）、Kwak-TIRADS、韩国甲状腺影像报告和数据系统（K-TIRADS）、欧洲甲状腺影像报告和数据系统（EU-TIRADS）、美国甲状腺协会（ATA）和中国甲状腺影像报告和数据系统（C-TIRADS），在鉴别甲状腺结节（TN）良恶性方面的诊断性能。
材料与方法
在这项单中心研究中，回顾性评估了2007年1月至2023年9月期间经手术或细针穿刺活检（FNAB）病理证实的TN的超声（US）图像，并根据六种不同的现有指南进行分类。计算每个指南的曲线下面积（AUC）、敏感性、特异性、阳性和阴性预测值（分别为PPV和NPV）以及恶性漏诊率（MRM）。
结果
共纳入829个TN（n = 234个恶性和n = 595个良性）。ACR-TIRADS的AUC、敏感性、特异性、PPV、NPV和准确性分别为0.786、99.8%、27.1%、31.92%、99.73%和54.6%；Kwak-TIRADS分别为0.839、97.8%、42.1%、36.29%、98.11%和63.1%；K-TIRADS分别为0.797、97.6%、41.6%、36.01%、84.85%和62.8%；EU-TIRADS分别为0.766、97.8%、35.6%、33.89%、97.92%和59.1%；ATA分别为0.788、97.5%、49.8%、32.86%、88.16%和64.2%；C-TIRADS分别为0.842、0%、92.8%、54.3%、39.53%、90.42%和68.8%。ACR-/Kwak-/K-/EU-/ATA-/C-TIRADS的MRM分别为2.2%、0.5%、2.9%、2.5%、3.3%和0.1%。
结论
六种不同的现有TIRADS指南能够有效地鉴别恶性TN和良性TN，诊断性能相似。然而，在本系列中，C-TIRADS的AUC最高，MRM低于其他指南。
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