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Application of ultrasound-based thyroid imaging reporting and data system for assessing thyroid nodules with suspected malignancy
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Y. Wu   , D. Liu , Y. Zhou , X. Xin , A. Guo |
| Physical Examination Center, The Second Hospital of Hebei Medical University, Shijiazhuang 050000, Hebei Province, China , ainanguo902@163.com |
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Abstract: (8 Views) |
Background: To evaluate the effectiveness of the Kwak Thyroid Imaging Reporting and Data System (TI-RADS) in preoperatively identifying suspicious malignant thyroid nodules (MTNs) and to investigate size-dependent ultrasound features associated with malignancy. Materials and Methods: This study reviewed 155 patients (212 nodules suspected of thyroid cancer) who underwent surgical treatment at The Second Hospital of Hebei Medical University between June 2015 and December 2019. Preoperative ultrasound findings were classified using the Kwak TI-RADS system based on five features: solid composition, hypoechogenicity, irregular/lobulated margin, aspect ratio ≥1, and microcalcifications. Nodules were categorized into TI-RADS 3–5, with histopathology serving as the diagnostic benchmark. The positive predictive value (PPV), sensitivity, specificity, negative predictive value (NPV), and accuracy were calculated. Additionally, ultrasonographic characteristics of papillary malignant nodules (≤1 cm) were compared to those of larger malignant nodules (>1 cm). Results: Of the 212 nodules, histopathology identified 193 as malignant and 19 as benign. The TI-RADS demonstrated a PPV of 96.94%, sensitivity of 98.45%, specificity of 68.42%, NPV of 81.25%, and accuracy of 95.75%. Size-stratified analysis revealed distinct imaging phenotypes: microcarcinomas (n = 119) were more frequently associated with an aspect ratio ≥1 (80.67%) and microcalcifications (57.98%), while larger malignant nodules (n = 74) exhibited higher rates of coarse calcifications (24.32%) and increased vascularity (grade 2/3: 32.43%). The two groups showed significant differences in aspect ratio, type of calcification, and vascularity (p<0.01). Conclusion: The TI RADS classification effectively predicts the diagnosis of suspicious MTN. |
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| Keywords: Thyroid nodule, microcarcinomas, ultrasonography, classification system, diagnosis, differential, retrospective studies. |
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Full-Text [PDF 1191 kb]
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Type of Study: Original Research |
Subject:
Radiation Biology
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