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1.
Beijing Da Xue Xue Bao Yi Xue Ban ; 51(6): 1067-1070, 2019 Dec 18.
Artigo em Chinês | MEDLINE | ID: mdl-31848506

RESUMO

OBJECTIVE: To summarize and evaluate the value of applying the thyroid imaging reporting and data system (TI-RADS) released by American College of Radiology (ACR) in 2017 of the thyroid classification, and to propose an optimized classification method based on the result to facilitate more accurate and precise risk stratification of thyroid nodules. METHODS: In the study, 342 thyroid nodules assessed by 2017 ACR TI-RADS were retrospectively analyzed. Each nodule had a score, and all the scores of nodules were compared with the pathological results. The proportion of malignant nodules in different scoring ranges was obtained. The diagnostic efficacy of all nodules, nodules above 1 cm and less than or equal to 1 cm was evaluated by ROC curve, respectively. RESULTS: The AUC of all nodules, nodules above 1 cm and less than or equal to 1 cm were 0.907, 0.936 and 0.717, respectively. With the increase of the scores, the proportion of benign nodules decreased gradually, and the proportion of malignant nodules increased, especially nodules of 4-6 scores increased significantly. Based on the proportion of malignant nodules with 3 scores, the proportion of malignant nodules with 4, 5 and 6 scores increased 1.6, 3.8 and 5.3 times, respectively. The proportion of malignant nodules with 6-8 scores was 81%-84%, while the proportion of malignant nodules with 9 scores or more was 93%-94%. According to the distribution characteristics of malignant nodules, the classification of TI-RADS was adjusted. TI-RADS 4 was divided into TI-RADS 4a, TI-RADS 4b and TI-RADS 4c, corresponding to 4, 5 and 6-8 scores respectively, while the nodules with 9 scores or more were divided into TI-RADS 5. CONCLUSION: 2017 ACR TI-RADS has high diagnostic value for thyroid nodules above 1 cm, but it is not so effective for the nodules less than or equal to 1 cm. According to the proportion distribution of malignant nodules in different scoring ranges, appropriate adjustment of classification will be more accurate and precisely predict the malignant risk of nodules.


Assuntos
Nódulo da Glândula Tireoide , Sistemas de Dados , Humanos , Estudos Retrospectivos , Ultrassonografia
3.
Zhong Nan Da Xue Xue Bao Yi Xue Ban ; 44(9): 1071-1077, 2019 Sep 28.
Artigo em Chinês | MEDLINE | ID: mdl-31645499

RESUMO

OBJECTIVE: To study the clinical application value of ultrasound-guided fine needle aspiration biopsy (US-FNAB) and contrast-enhanced ultrasound (CEU) in the diagnosis of thyroid imaging reported and data system Grade 4 (TI-RADS 4) nodules.
 Methods: A retrospective analysis of 134 patients with thyroid nodules surgery were selected, and their results of preoperative color Doppler ultrasonography were TI-RADS 4. The data of US-FNAB and CEU before operation and the results of pathological section after operation were collected. The pathological results were taken as the gold standard, and the specimens obtained by US-FNAB puncture were used for HE staining and cytological diagnosis. The sensitivity, specificity, accuracy and the cost were calculated for CEU and US-FNAB, respectively. The diagnostic efficacy of the 2 methods was compared.
 Results: Of 134 thyroid nodules, there were 131 malignant nodules (97.76%) and 3 benign ones (2.24%). The sensitivity of US-FNAB and CEU were 87.02% and 93.89% respectively. The specificity of US-FNAB and CEU were 100.00% and 66.67%. The accuracy of US-FNAB and CEU were 87.31% and 93.28% respectively. Comparisons of the diagnostic accuracy were performed by χ2 test. There was no significant difference in sensitivity between CEU and US-FNAB (P>0.05). However, the sensitivity of US-FNAB and CEU were 87.50% and 100.00%, respectively, when the maximum diameter of nodule was less than 10 mm, and there was statistical significance (P<0.05). The sensitivity of US-FNAB and CEU were 92.73% and 85.45%, respectively, when the maximum diameter of nodule was more than 10 mm, and there was no statistical significance (P>0.05). The cost and risk of US-FNAB was higher than those of CEU.
 Conclusion: The sensitivity of US-FNAB is higher than that of CEU for thyroid nodules with the diameter larger than 10 mm. With high detection rate, good safety and low cost, CEU can still be used for thyroid nodules with the diameter less than 10 mm, which is diagnosed as negative nodules by US-FNAB.


Assuntos
Neoplasias da Glândula Tireoide , Nódulo da Glândula Tireoide , Biópsia por Agulha Fina , Sistemas de Dados , Humanos , Estudos Retrospectivos , Sensibilidade e Especificidade
4.
Zhonghua Yi Xue Za Zhi ; 99(31): 2455-2458, 2019 Aug 20.
Artigo em Chinês | MEDLINE | ID: mdl-31434427

RESUMO

Objective: To determine whether clinically significant prostate cancer (PCa) and prostatitis in the peripheral zone can be distinguished using prostate imaging reporting and data system version 1 (PI-RADS V1) and version 2(PI-RADS V2). Methods: Between September 2010 and August 2016, mpMRI data of 77 patients with PCa and 29 prostatitis obtained at 3.0 T were collected in Zhangjiagang Hospital Affiliated to Soochow University. Every lesion was scored according to PI-RADS (V1 and V2), as well as a sum score and a PI-RADS V2 score. The non-parametric Kruskal-Wallis test was used to assess differences between PCa and prostatitis regarding PS3, PS4 and PI-RADS V2 score. The diagnostic performance of PI-RADS V1 and V2 for detection of prostatitis in peripheral zone was compared by analyzing ROC curve. Results: The PI-RADS V1 score for PS3, PS4 and the PI-RADS V2-score were all significantly higher for PCa (PS3:12.1±2.1; PS4:16.2±2.9; V2:4.6±0.8) than for prostatitis (PS3:8.0±0.7; PS4:10.6±1.0; V2:3.0±0.5) (all P<0.01). Of these parameters, PS4 achieved the highest predictive value for the presence of prostatitis with an AUC of 0.937, sensitivity and specificity were 87.0%, 97.0% with a threshold of 12.5. Conclusion: Prostatitis can be differentiated from clinically significant PCa in peripheral zone on mpMRI using PI-RADS system, PS4 achieved better results compared to PS3 and V2.


Assuntos
Neoplasias da Próstata , Prostatite , Sistemas de Dados , Humanos , Imagem por Ressonância Magnética , Masculino , Estudos Retrospectivos
6.
Eur J Radiol ; 117: 184-192, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31307646

RESUMO

PURPOSE: To assess diagnostic validity and reproducibility of Thyroid Imaging Reporting and Data System (TI-RADS) for interpretation of thyroid nodules by thyroid ultrasonography (US). METHOD: A prospective multicentre study initially included 557 patients with clinically suspected thyroid nodules. After exclusion, a final cohort of 380 patients with 948 thyroid nodules detected by US were enrolled. Based on American College of Radiology (ACR) TI-RADS, three radiologists analysed all US examinations independently and assigned a TI-RADS category to each thyroid nodule. The final diagnosis was based on cytology which was used as reference standard for calculating diagnostic performance of TI-RADS for predicting malignant thyroid nodules. The Fleiss and weighted kappa (κ) statistics were applied to assess inter-observer agreement of morphological features and TI-RADS scoring results for thyroid nodules. Additionally, we made a simple screening among referring clinicians to assess the clinical response to application of TI-RADS. RESULTS: A total of 948 thyroid nodules were evaluated; 136 (14.3%) were malignant, and 812 (85.7%) were benign. The papillary carcinoma was the most common malignant thyroid nodules (81.6%). The best cut-off value for predicting malignant thyroid nodules was > TR3. On a lesion-based analysis, the TI-RADS had a sensitivity, specificity, and an accuracy of 98.3%, 90.9%, and 92.1%, respectively when regarding those thyroid nodules classified as > TR3 for predicting malignancy. The inter-observer agreement of the TI-RADS category was good (κ = 0.636). Ninety percent of referring clinicians accept TI-RADS. CONCLUSIONS: TI-RADS improves diagnostic performance of US for predicting malignant thyroid nodules with high validity and high reproducibility.


Assuntos
Sistemas de Dados , Sistemas de Informação em Radiologia , Nódulo da Glândula Tireoide/patologia , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Guias de Prática Clínica como Assunto , Estudos Prospectivos , Padrões de Referência , Reprodutibilidade dos Testes , Adulto Jovem
9.
Ultraschall Med ; 40(4): 495-503, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31137050

RESUMO

PURPOSE: To evaluate the diagnostic performance of strain ratio elastography (SRE) and shear wave elastography (SWE) alone and in combination with Thyroid Imaging Reporting and Data System (TIRADS) classification parameters to improve differentiation between benign and malignant thyroid nodules. MATERIALS AND METHODS: In this prospective study benign (n = 191) and malignant (n = 52) thyroid nodules were examined with high-resolution ultrasound (US) features using the TIRADS lexicon and SRE semiquantitative and SWE quantitative findings using histology or cytology as the gold standard with a 12-month follow-up. Sensitivity (Se), specificity (Sp) and the area under the ROC curve (AUROC) were used to evaluate the diagnostic performance of each feature and combinations of the methods. RESULTS: TIRADS score showed a sensitivity of 59.6 %, a specificity of 83.8 % with an AUROC of 0.717, a PPV of 50.0 % and an NPV of 88.4 %. SRE yielded the highest performance with a sensitivity of 82.7 %, a specificity of 92.7 % with AUROC of 0.877, a PPV 75.4 % and an NPV of 95.2 %. SWE (kPa) had a sensitivity and specificity of 67.3 % and 82.7 %, respectively, with an AUROC of 0.750, a PPV of 51.5 % and an NPV of 90.3 %. Differences were significant for SRE only but not for SWE. CONCLUSION: Ultrasound elastography may improve thyroid nodule discrimination. In particular, SRE has a better performance than TIRADS classification, while their combination improves sensitivity.


Assuntos
Técnicas de Imagem por Elasticidade , Nódulo da Glândula Tireoide , Sistemas de Dados , Humanos , Estudos Prospectivos , Sensibilidade e Especificidade , Nódulo da Glândula Tireoide/classificação , Nódulo da Glândula Tireoide/diagnóstico por imagem
11.
Stud Health Technol Inform ; 258: 146-150, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30942733

RESUMO

BACKGROUND: The nationwide data infrastructure project HiGHmed strives for achieving semantic interoperability through the use of openEHR archetypes. Therefore, a knowledge governance framework defining collaborative modelling processes has been established. For long-sustained success and the creation of high-quality archetypes, continuous monitoring is vital. OBJECTIVES: To present an update on archetype modelling and governance framework establishment in HiGHmed. METHODS: Qualitative and quantitative analyses of the progress in establishing modelling groups, roles and users, realizing modelling workflows, and modelling archetypes. RESULTS: Currently, 25 modellers and 17 domain experts are participating. 79 archetypes have been identified, from which 69 are pre-existing and internationally published; completion rates of review rounds are satisfying but improvable. CONCLUSIONS: The governance framework is valuable to make the activities manageable and to accelerate modelling. Combined with highly engaged data stewards and clinicians, a reasonable number of archetypes have already been developed.


Assuntos
Registros Eletrônicos de Saúde , Semântica , Sistemas de Dados
12.
Zhong Nan Da Xue Xue Bao Yi Xue Ban ; 44(3): 277-284, 2019 Mar 28.
Artigo em Chinês | MEDLINE | ID: mdl-30971520

RESUMO

OBJECTIVE: To explore the value of prostate imaging reporting and data system version 2 (PI-RADS V2) combined with quantitative parameters derived from apparent diffusion coefficient (ADC) map in the diagnosis of peripheral zone prostate cancer.
 Methods: A total of 50 patients who underwent prostate multiparametric MRI (mpMRI) with suspicious peripheral nodules were retrospectively enrolled, and all patients were biopsy-proven histologically. Two radiologists analyzed the position and category of peripheral zone lesions based on PI-RADS V2. Then 12 ADC quantitative parameters were calculated regarding each lesion on the ADC map by post-processing software. The lesions were divided into malignant group and benign group according to histopathological findings. The ADC quantitative parameters between groups were compared, and stepwise logistic regression analysis was used to build a discriminative model. Receiver operating characteristic (ROC) curve and decision curve analysis (DCA) were performed to evaluate the diagnostic power and clinical benefit.
 Results: Twenty-eight peripheral zone prostate malignant lesions and 25 benign lesions were obtained finally. The area under the ROC curve, sensitivity and specificity to differentiate peripheral zone prostate malignant from benign lesions were as follows: 0.803, 60.71%, 92.00% (PI-RADS V2 score), 0.857, 89.29%, 76.00% (ADC model), and 0.891, 71.43%, 92.00% (combined model), respectively. The discriminative power of the combined model was significantly improved compared with PI-RADS V2 score (P=0.012). The combined model had relatively optimal overall net benefit, which outperformed the PI-RADS V2 score when threshold probability varied in the range of 0.05-0.27 and 0.46-0.81.
 Conclusion: PI-RADS V2 combined with quantitative analysis of ADC map improve the power in discriminating peripheral zone prostate cancer from benign lesions, and the clinical benefit as well.


Assuntos
Neoplasias da Próstata , Sistemas de Dados , Imagem de Difusão por Ressonância Magnética , Humanos , Imagem por Ressonância Magnética , Masculino , Neoplasias da Próstata/diagnóstico por imagem , Estudos Retrospectivos
13.
Eur J Radiol ; 114: 111-119, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31005160

RESUMO

OBJECTIVE: To compare the diagnostic performance between Prostate Imaging Reporting and Data System version 1(PI-RADS v1) and PI-RADS v2 for detection of prostate cancer (PCa). METHODS: A systematic literature search was performed from inception to September 31, 2018, in following databases MEDLINE, EMBASE, Cochrane Library, Google Scholar, in addition to Chinese National Knowledge Infrastructure (CNKI) and Wanfang Data database. Sensitivity and specificity of individual studies along with summary estimates were calculated and presented in forest plots. Multiple subgroup analyses and meta-regression were performed to investigate the heterogeneity. Quality of included studies was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 tool. RESULTS: 14 studies involving head to head comparison between PI-RADS v1 and v2 were included, with a total of 1682 patients. The pooled sensitivity for PI-RADS v1 and PI-RADS v2 were 85.37% (95% CI 79.29%-89.89%) and 87.79% (95% CI 79.84%-92.88%), with pooled specificity of 77.26% (95% CI 57.29%-89.58%) and 76.73% (95% CI 58.69%-88.44%), respectively. There was no substantial difference in diagnostic accuracy between PI-RADS v1 and PI-RADS v2 (P = 0.57 for sensitivity and P = 0.96 for specificity). Multiple subgroup analyses and meta-regression suggested these two scoring systems had comparable diagnostic performance on magnetic field strength, zonal anatomy, and outcome assessment. For the transitional zone, it seemed that PI-RADS v2 had higher sensitivity than PI-RADS v1 (90.1% vs. 80.59%), but the difference was not substantial (P = 0.17). CONCLUSION: PI-RADS v2 has slightly higher sensitivity but at the expense of minor decreased specificity. Thus, on the whole PI-RADS v1 and PI-RADS v2 have comparable diagnostic accuracy.


Assuntos
Biópsia Guiada por Imagem , Imagem por Ressonância Magnética , Próstata/diagnóstico por imagem , Próstata/patologia , Neoplasias da Próstata/diagnóstico por imagem , Confiabilidade dos Dados , Sistemas de Dados , Humanos , Imagem por Ressonância Magnética/métodos , Masculino , Sensibilidade e Especificidade
15.
Eur Radiol ; 29(7): 3761-3771, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30859282

RESUMO

OBJECTIVES: To evaluate how sarcomatoid carcinomas (SCs) would be classified on magnetic resonance imaging (MRI) by using the Liver Imaging Reporting and Data System (LI-RADS) and to assess imaging features of SC compared with other hepatic malignancies. METHODS: We retrieved 184 patients with pathologically confirmed SC (n = 46), hepatocellular carcinoma (HCC, n = 92), and intrahepatic cholangiocarcinoma (iCCA, n = 46) diagnosed between January 2006 and December 2017. Two readers independently reviewed MRI according to LI-RADS v2017. Classification rate of SC, as probably or definitely malignant but not specific for HCC (LR-M), was calculated. LR-TIV (tumor in vein) was subclassified as either 5V or MV. MRI features were compared between SC, HCC, and iCCA and between SC of LR-M and non-LR-M categories. RESULTS: Chronic liver disease was present in 71.7% (33/46) of patients with SC, and LI-RADS was applied for these patients. SC was classified as LR-M in 24 (72.7%) of 33 patients at risk. SCs that had been classified as LR-4/5/5V were significantly smaller (median, 1.9 cm; range, 1.0-4.2 cm) than SCs classified as LR-M/MV (median, 4.3 cm; range, 1.3-20.6 cm) on independent t test (p = 0.012). SCs commonly showed MRI features similar to iCCAs than to HCCs. Targetoid appearance and capsular retraction were more frequent in iCCA than in SC (p ≤ 0.009) on Pearson's chi-squared test or Fisher's exact test. CONCLUSION: Most SCs can be classified as LR-M on MRI, but small lesions may be indistinguishable from HCCs. KEY POINTS: • Most sarcomatoid carcinomas (SCs) are classified as LR-M on MRI by using LI-RADS v2017. • SC showed various LR-M features similar to those of intrahepatic cholangiocarcinoma. • Size of LR-4/5/5V SC was significantly smaller than that of LR-M/MV SC.


Assuntos
Carcinoma Hepatocelular/diagnóstico , Sistemas de Dados , Neoplasias Hepáticas/diagnóstico , Fígado/patologia , Imagem por Ressonância Magnética/métodos , Adulto , Biópsia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
16.
Clin Hemorheol Microcirc ; 72(3): 279-291, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30856102

RESUMO

OBJECTIVE: This study was conducted to investigate the diagnostic performance of Virtual Touch Tissue Imaging and Quantification (VTIQ), combined with the American College of Radiology Thyroid Imaging Reporting and Data System (ACR TI-RADS) in differentiating malignant and benign thyroid nodules. METHODS: A total of 130 thyroid nodules in 128 patients were included. The diagnostic performance of conventional ultrasound (US), VTIQ, and the combination of these two techniques was calculated and compared according to the area under the receiver operating characteristic curve (AUROC), for sensitivity, specificity, and accuracy. RESULTS: The sensitivity and specificity for the ACR TI-RADS were 98.6% (72/73) and 24.6% (14/57), respectively. There was a strong agreement with ACR TI-RADS categories of thyroid nodules (all ICCs > 0.60). With an optimal cutoff value of 2.46 m/s, the sensitivity and specificity of the minimal shear wave velocity (SWVmin) were 87.7% (64/73) and 70.2% (40/57). By applying this value to downgrade or upgrade ACR TI-RADS, the specificity significantly increased from 24.6% (14/57) to 47.4% (27/57; P < 0.05) and the sensitivity remained at 98.6% (72/73). CONCLUSIONS: VTIQ combined with ACR TI-RADS could improve the specificity of the differential diagnosis of thyroid nodules without a loss of sensitivity.


Assuntos
Sistemas de Dados , Nódulo da Glândula Tireoide/diagnóstico por imagem , Nódulo da Glândula Tireoide/diagnóstico , Ultrassonografia/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Medição de Risco , Nódulo da Glândula Tireoide/patologia , Estados Unidos
17.
Clin Hemorheol Microcirc ; 72(3): 317-326, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30856106

RESUMO

OBJECTIVE: This study aimed to evaluate the impact of thyroid nodule sizes on the diagnostic performance of Korean thyroid imaging reporting and data system (TIRADS) and contrast-enhanced ultrasound (CEUS). METHODS: In total, 308 consecutive patients with 382 thyroid nodules underwent US-guided FNA or surgery were included in this retrospective study. The nodule size was classified into 3 categories: ≤10 mm (group A), 10-20 mm (group B), and ≥20 mm (group C). We compared the risk of malignancy in each subgroup, categorized according to the TIRADS and CEUS patterns. RESULTS: In group A, the differences in diagnostic value between TIRADS and CEUS were significant (AUC: 0.804 vs 0.733, P = 0.028, sensitivity: 81.8% vs 72.7%, P = 0.013, specificity: 88.9% vs 79.4%, P = 0.011). In group B, the AUC (0.897), sensitivity (88.1%) and specificity (91.9%) of CEUS were highest. In group C, the specificity of CEUS was significantly higher compared with TIRADS classification (90.8% vs 82.9%, P = 0.023), while the sensitivity and AUC showed no significant difference between the two models (84.2% vs 81.5%, P > 0.406, 0.848 vs 0.820, P = 0.545). CONCLUSIONS: Nodule size influences the diagnostic accuracy of the two methods. TIRADS have best value in nodules ≤10 mm, while CEUS perform best for differentiating lesions >10 mm, especially in lesions ≥20 mm.


Assuntos
Meios de Contraste/uso terapêutico , Sistemas de Dados , Projetos de Pesquisa , Neoplasias da Glândula Tireoide/diagnóstico por imagem , Nódulo da Glândula Tireoide/patologia , Ultrassonografia/métodos , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Adulto Jovem
18.
Endocr Pract ; 25(5): 413-422, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30720343

RESUMO

Objective: This study compares the American Thyroid Association (ATA) classification system with the 2017 American College of Radiology (ACR) Thyroid Imaging Reporting and Data System (TI-RADS) for predicting cancer risk in thyroid nodules. Methods: This is a retrospective review of ultrasound imaging of all adult patients with thyroid nodules >5 mm who underwent thyroidectomy at a tertiary care hospital in 2016. We assessed the ability of either system to predict malignancy based on surgical histopathology. Sensitivity, specificity, negative predictive values (NPV) and positive predictive values (PPV), and area-under-the-curve (AUC) were calculated and compared using McNemar's, Fisher exact, or DeLong's tests. Results: Three hundred and twenty-three nodules from 213 adults were included. Median patient age was 55 years; 75.6% were female. 27.2% nodules were malignant. Both ATA and ACR TI-RADS provide effective diagnostic performance, a sensitivity of 77.3% versus 78.4%, respectively, a specificity of 76.6% versus 73.2%, respectively, a PPV of 55.3% versus 52.3%, respectively, and a NPV of 90% for both. The level of agreement between the two classification systems was almost perfect (weighted Kappa statistic = 0.93, AUC 0.77 ATA versus 0.76 TI-RADS [P = .18]). However, of the 40 (TI-RADS level 3) TR3 nodules (<2.5 cm), 10% were malignant, and of the 31 (TI-RADS level 4) TR4 nodules (<1.5 cm), 38% were malignant. Conclusion: The ATA and TI-RADS classification systems appear to have similar diagnostic value for predicting thyroid cancer. However, subanalysis of TR3 and TR4 nodules with consideration of size criteria showed that there is a higher risk of missing a malignancy if the ACR TI-RADS recommendation is followed. These results should be validated in a different patient cohort with a lower incidence of cancer. Abbreviations: ACR = American College of Radiology; ATA = American Thyroid Association; FNA = Fine Needle Aspiration; κ = weighted Kappa statistic; NPV = negative predictive values; PPV = positive predictive values; TI-RADS = Thyroid Imaging Reporting and Data System; TR1 = TI-RADS level 1; TR2 = TI-RADS level 2; TR3 = TI-RADS level 3; TR4 = TI-RADS level 4; TR5 = TI-RADS level 5.


Assuntos
Ultrassonografia , Sistemas de Dados , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Nódulo da Glândula Tireoide
20.
Eur Radiol ; 29(9): 4871-4878, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30715590

RESUMO

OBJECTIVES: We aim to compare the diagnostic performance to assess thyroid nodules and reliability for recommending fine needle aspiration biopsy (FNAB) between American College of Radiology thyroid image reporting and data system (ACR TI-RADS) and American Thyroid Association (ATA) guidelines. METHODS: In total, this retrospective study included 1001 consecutive thyroid nodules in 918 patients from May 2016 to December 2017. US features of the thyroid nodules, including composition, echogenicity, shape, margins, echogenic foci, and size, were reviewed and were classified according to ACR TI-RADS and ATA guidelines, respectively. The diagnostic performance to assess thyroid nodules and reliability for recommending fine needle aspiration biopsy were compared between ACR TI-RADS and ATA guidelines. RESULTS: Of the 1001 thyroid nodules, 609 (60.8%) were benign and 392 (39.2%) were malignant. The sensitivity, specificity, PPV, NPV, and accuracy were 96.7%, 77.3%, 73.3%, 97.3%, and 84.9%, respectively, for ACR TI-RADS and 99.2%, 16.1%, 43.2%, 97.0%, and 48.7%, respectively, for ATA guidelines. AUC of ACR TI-RADS was significantly greater than ATA guidelines (0.935 (0.918, 0.949) vs 0.884 (0.862, 0.903), p < 0.001). Biopsy yield of malignancy, biopsy rate of malignancy, and unnecessary FNAB rate were 59.5%, 91.3%, and 40.5%, respectively, for ACR TI-RDS and 38.5%, 97.4%, and 61.5%, respectively, for ATA guidelines. CONCLUSIONS: ACR TI-RADS was more accurate than ATA guidelines for differentiating malignant thyroid nodules from benign nodules and more reliable than ATA guidelines for recommending thyroid nodules for FNAB. KEY POINTS: • Malignant risk of thyroid nodules can be stratified by ultrasound. • American College of Radiology guidelines were more accurate for differentiating malignant thyroid nodules from benign nodules. • American College of Radiology guidelines were more reliable for recommending thyroid nodules for biopsy.


Assuntos
Nódulo da Glândula Tireoide/patologia , Adolescente , Adulto , Idoso , Biópsia por Agulha Fina/métodos , Sistemas de Dados , Feminino , Humanos , Biópsia Guiada por Imagem/métodos , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Estudos Retrospectivos , Medição de Risco/métodos , Sensibilidade e Especificidade , Ultrassonografia de Intervenção/métodos , Adulto Jovem
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