Can the American Thyroid Association, K-Tirads, and Acr-Tirads Ultrasound Classification Systems Be Used to Predict Malignancy in Bethesda Category IV Nodules?
| Autor: | Wei Yang, Machelle D. Wilson, Michael J. Campbell, Ghaneh Fananapazir, Jennifer R LaRoy |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Thyroid nodules
medicine.medical_specialty ultrasound grading scheme Endocrinology Diabetes and Metabolism Clinical Sciences 030209 endocrinology & metabolism Malignancy Paediatrics and Reproductive Medicine 03 medical and health sciences Bethesda Category 4 Endocrinology & Metabolism 0302 clinical medicine Endocrinology Cytology medicine Humans 030212 general & internal medicine Thyroid Neoplasms Thyroid Nodule ACR-TIRADS Grading (tumors) K-TIRADS Cancer Retrospective Studies Ultrasonography medicine.diagnostic_test business.industry Prevention Thyroid Nodule (medicine) Retrospective cohort study General Medicine medicine.disease United States Fine-needle aspiration medicine.anatomical_structure Biomedical Imaging Radiology medicine.symptom business |
| Zdroj: | Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists, vol 26, iss 9 |
| ISSN: | 1530-891X |
| Popis: | Management of thyroid nodules with Bethesda category III and IV cytology on fine needle aspiration (FNA) is challenging as they cannot be adequately classified as benign or malignant. Ultrasound (US) patterns have demonstrated the utility in evaluating the risk of malignancy (ROM) of Bethesda category III nodules. This study aims to evaluate the value of 3 well-established US grading systems (American Thyroid Associationlsqb;ATA], Korean Thyroid Imaging Reporting and Data Systemlsqb;Korean-TIRADS], and The American College of Radiology Thyroid Imaging Reporting and Data Systemlsqb;ACR-TIRADS]) in determining ROM in Bethesda category IV nodules.Ninety-two patients with 92 surgically resected thyroid nodules who had Bethesda category IV cytology on FNA were identified. Nodule images were retrospectively graded using the 3 systems in a blinded manner. Associations between US risk category and malignant pathology for each system were analyzed.Of the 92 nodules, 56 (61%) were benign and 36 (39%) were malignant. Forty-seven per cent of ATA high risk nodules, 53% of K-TIRADS category 5 nodules, and 50% of ACR-TIRADS category 5 nodules were malignant. The ATA high-risk category had 25% sensitivity, 82% specificity, 47% positive predictive value (PPV) for malignancy. K-TIRADS category 5 had 25% sensitivity, 85% specificity, 53% PPV for malignancy. ACR-TIRADS category 5 had 25% sensitivity, 84% specificity, 50% PPV for malignancy. None of the 3 grading systems yielded a statistically significant correlation between US risk category and the ROM (P = .30, .72, .28).The ATA, Korean-TIRADS, and ACR-TIRADS classification systems are not helpful in stratifying ROM in patients with Bethesda category IV nodules. Clinicians should be cautious of using ultra-sound alone when deciding between therapeutic options for patients with Bethesda category IV thyroid nodules. |
| Databáze: | OpenAIRE |
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