Zeng Weibo, He Yanni, Xu Renhao, Mai Wuping, Chen Yufan, Li Sushu, Yi Wenhong, Ma Li, Xiong Ran, Liu Hongmei
The Second School of Clinical Medicine, Southern Medical University, Guangzhou, P.R. China; Department of Ultrasound, Institute of Ultrasound in Musculoskeletal Sports Medicine, The Affiliated Guangdong Second Provincial General Hospital of Jinan University, Guangzhou, Guangdong, P.R. China.
Department of Ultrasound, Institute of Ultrasound in Musculoskeletal Sports Medicine, The Affiliated Guangdong Second Provincial General Hospital of Jinan University, Guangzhou, Guangdong, P.R. China.
Ultrasound Med Biol. 2025 Aug;51(8):1370-1376. doi: 10.1016/j.ultrasmedbio.2025.05.009. Epub 2025 May 31.
To evaluate the value of combining American College of Radiology (ACR) Thyroid Imaging Reporting and Data System (TI-RADS) with the Demetics ultrasound diagnostic system in reducing the rate of fine-needle aspiration (FNA) biopsies for thyroid nodules.
A retrospective study analyzed 548 thyroid nodules from 454 patients, all meeting ACR TI-RADS guidelines (category ≥3 and diameter ≥10 mm) for FNA. Nodule was reclassified using the combined ACR TI-RADS and Demetics system (De TI-RADS), and the biopsy rates were compared.
Using ACR TI-RADS alone, the biopsy rate was 70.6% (387/548), with a positive predictive value (PPV) of 52.5% (203/387), an unnecessary biopsy rate of 47.5% (184/387) and a missed diagnosis rate of 11.0% (25/228). Incorporating Demetics reduced the biopsy rate to 48.1% (264/548), the unnecessary biopsy rate to 17.4% (46/265) and the missed diagnosis rate to 4.4% (10/228), while increasing PPV to 82.6% (218/264). All differences between ACR TI-RADS and De TI-RADS were statistically significant (p < 0.05).
The integration of ACR TI-RADS with the Demetics system improves nodule risk assessment by enhancing diagnostic and efficiency. This approach reduces unnecessary biopsies and missed diagnoses while increasing PPV, offering a more reliable tool for clinicians and patients.
评估美国放射学会（ACR）甲状腺影像报告和数据系统（TI-RADS）与德美特超声诊断系统相结合在降低甲状腺结节细针穿刺活检（FNA）率方面的价值。
一项回顾性研究分析了来自454例患者的548个甲状腺结节，所有结节均符合ACR TI-RADS指南（类别≥3且直径≥10 mm）进行FNA。使用ACR TI-RADS和德美特系统（De TI-RADS）联合对结节进行重新分类，并比较活检率。
仅使用ACR TI-RADS时，活检率为70.6%（387/548），阳性预测值（PPV）为52.5%（203/387），不必要活检率为47.5%（184/387），漏诊率为11.0%（25/228）。纳入德美特系统后，活检率降至48.1%（264/548），不必要活检率降至17.4%（46/265），漏诊率降至4.4%（10/228），同时PPV提高到82.6%（218/264）。ACR TI-RADS与De TI-RADS之间的所有差异均具有统计学意义（p < 0.05）。
ACR TI-RADS与德美特系统相结合可通过提高诊断准确性和效率来改善结节风险评估。这种方法减少了不必要的活检和漏诊，同时提高了PPV，为临床医生和患者提供了更可靠的工具。
