Tobcu Eren, Karavaş Erdal, Yılmaz Gülden Taşova, Topçu Bilgin
Department of Radiology, Bandırma Onyedi Eylul University School of Medicine, 10200 Balıkesir, Türkiye.
Department of Pathology, Bandırma Research and Training Hospital, 10200 Balıkesir, Türkiye.
Diagnostics (Basel). 2025 Apr 16;15(8):1015. doi: 10.3390/diagnostics15081015.
: Thyroid nodules are commonly observed in neck ultrasonography. Most nodules are benign; hence, several nodules require biopsy to accurately identify the malignant ones. Numerous risk classification guidelines have been developed for thyroid nodules, varying in their indications for fine-needle aspiration biopsy (FNAB). The aim of this study is to evaluate the performances of three internationally recognized thyroid imaging reporting and data systems (TIRADS) for risk stratification of malignancy in comparison to one another. : A total of 225 thyroid nodules with definitive FNAB cytology or histopathological diagnoses were included in this study. Various ultrasound (US) features were classified into categories based on three TIRADS editions. The guidelines were assessed regarding sensitivity, specificity, predictive values, and diagnostic accuracy to compare diagnostic value. : The American College of Radiology (ACR)-TIRADS demonstrated the best diagnostic accuracy (63.1%), the highest specificity (58.7%) and positive predictive value (36.3%), among three different TIRADS systems. Korean (K)-TIRADS exhibited the highest sensitivity (94.2%), negative predictive value (96.1%), and the most favorable negative likelihood ratio (0.13). The European (EU)-TIRADS had a sensitivity of 90.4%, specificity of 48.6%, and diagnostic accuracy of 58.2%, ranking between the other two guidelines across most parameters. : The rigorous use of the guidelines established by each of the three TIRADS systems would have markedly reduced the number of FNABs performed. The comparison of the three guidelines in our study indicated that they are effective screening methods for identifying malignant thyroid nodules. Among them, K-TIRADS showed the most effective diagnostic performance in sensitivity, while ACR-TIRADS yielded the best specificity.
甲状腺结节在颈部超声检查中很常见。大多数结节是良性的；因此，一些结节需要进行活检以准确识别恶性结节。针对甲状腺结节已经制定了许多风险分类指南，细针穿刺活检（FNAB）的指征各不相同。本研究的目的是评估三种国际认可的甲状腺影像报告和数据系统（TIRADS）在恶性风险分层方面的相互性能。：本研究共纳入225个经明确FNAB细胞学或组织病理学诊断的甲状腺结节。根据三个TIRADS版本将各种超声（US）特征分类。评估这些指南的敏感性、特异性、预测值和诊断准确性以比较诊断价值。：在三种不同的TIRADS系统中，美国放射学会（ACR）-TIRADS表现出最佳的诊断准确性（63.1%）、最高的特异性（58.7%）和阳性预测值（36.3%）。韩国（K）-TIRADS表现出最高的敏感性（94.2%）、阴性预测值（96.1%）和最有利的阴性似然比（0.13）。欧洲（EU）-TIRADS的敏感性为90.4%，特异性为48.6%，诊断准确性为58.2%，在大多数参数上排名在其他两个指南之间。：严格使用三个TIRADS系统各自制定的指南将显著减少进行FNAB的数量。我们研究中对这三个指南的比较表明，它们是识别恶性甲状腺结节的有效筛查方法。其中，K-TIRADS在敏感性方面表现出最有效的诊断性能，而ACR-TIRADS产生了最佳的特异性。
