Comparison of ACR TI-RADS, Kwak TI-RADS, ATA guidelines and KTA/KSThR guidelines in combination with SWE in the diagnosis of thyroid nodules
Autor: | Wen-Jie Fu, Hua Liu, Bei-Li He, Wen Xu, Wei-Bing Zhang, Wen-Fang Deng |
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Rok vydání: | 2021 |
Předmět: |
Adult
Male Thyroid nodules Physiology Youden's J statistic 030218 nuclear medicine & medical imaging Diagnosis Differential Surgical pathology 03 medical and health sciences 0302 clinical medicine Physiology (medical) medicine Humans Thyroid Nodule Retrospective Studies Ultrasonography Shear wave elastography Receiver operating characteristic business.industry Ultrasound Hematology Middle Aged medicine.disease Area Under Curve 030220 oncology & carcinogenesis Practice Guidelines as Topic Elasticity Imaging Techniques Female Cardiology and Cardiovascular Medicine business Nuclear medicine Area under the roc curve |
Zdroj: | Clinical Hemorheology and Microcirculation. :1-12 |
ISSN: | 1875-8622 1386-0291 |
Popis: | OBJECTIVE: To compare the diagnostic efficacy of ACR TI-RADS, Kwak TI-RADS, ATA guidelines and KTA/KSThR guidelines in combination with shear wave elastography (SWE) for thyroid nodules. METHODS: The retrospective study included 566 thyroid nodules with maximum diameter≥5 mm which confirmed by FNA cytology or/and surgical pathology. The sensitivity, specificity, accuracy, Youden index of diagnosis of thyroid nodules by ACR TI-RADS, Kwak TI-RADS, ATA guidelines, KTA/KSThR guidelines and SWE were calculated. The ROC curve was drawn to determine the cut-off values of the four ultrasound classification systems and SWE Emax. The diagnostic efficacy of the four ultrasound classification systems in combination with SWE were calculated and compared with those of pre-combination. RESULTS: The ROC curves indicated that the cut-off value of ACR TI-RADS, Kwak TI-RADS, ATA guidelines, KTA/KSThR guidelines and Emax of SWE was TR5, 4c, high-suspicion, high-suspicion, and 41.7 kPa, respectively, and the area under the ROC curve (AUC) was 0.907(0.879–0.934), 0904(0.876–0.932), 0.894(0.863–0.924), 0.888(0.856–0.919), 0.886(0.859–0.913), respectively. After combination with SWE, the the sensitivities of the four ultrasound classification systems for the diagnosis of nodules were improved, and the differences were statistically significant (all P≤0.001); the specificities were decreased, but the differences were not statistically significant (all P > 0.05); the accuracies were improved, but only the difference of ACR TI-RADS was statistically significant (x2 = 4.45, P = 0.035); the differences in the AUCs were not significant (all P > 0.05). CONCLUSIONS: The four ultrasound classification systems and SWE all had high performance in the diagnosis of thyroid nodules. The four classification systems in combination with SWE were all beneficial to the differential diagnosis of nodules, and ACR TI-RADS in combination with SWE was more effective, especially for TR3 and TR4 nodules. |
Databáze: | OpenAIRE |
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