Virtual touch tissue imaging for differential diagnosis in ACR TI-RADS category 3-4 thyroid nodules: Conservative and aggressive methods.

IF 2.1 4区医学 Q3 HEMATOLOGY Clinical hemorheology and microcirculation Pub Date : 2023-01-01 DOI:10.3233/CH-231694

Kai-Mei Lian, Teng Lin

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Abstract

Purpose: Many Thyroid Imaging Reporting and Data System (TI-RADS) category 3-4 nodules are benign. Our study aimed to add virtual touch tissue imaging (VTI) to TI-RADS using two methods, namely conservative and aggressive, and to explore which method had better diagnostic performance and which method avoided more unnecessary biopsies.

Methods: From January 2016 to December 2021, we included 121 thyroid nodules classified as TI-RADS category 3-4 in 115 consecutive patients in this retrospective study. This study used the reference standard for pathological diagnosis by surgical resection or biopsy. The diagnostic performance of the different methods was evaluated and compared by receiver operating characteristic (ROC) and area under the ROC curve (AUC).

Results: In this study, the aggressive approach had the best diagnostic performance among TI-RADS alone, the conservative approach, and the aggressive approach (AUC: 0.863 versus 0.598, P = 0.0007; 0.863 versus 0.755, P = 0.0067). When we used an aggressive approach, 75.44% (43/57) of the 57 false-positive nodes diagnosed by TI-RADS were appropriately downgraded from TI-RADS category 4 to category 3, avoiding unnecessary biopsies.

Conclusion: VTI improves the diagnostic performance of TI-RADS. The aggressive approach of combining the TI-RADS with VTI would help reduce unnecessary biopsies.

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虚拟触摸组织成像在ACR TI-RADS分类3-4甲状腺结节鉴别诊断中的应用:保守和积极方法。

目的：许多甲状腺影像学报告和数据系统（TI-RADS）3-4类结节是良性的。我们的研究旨在使用保守和积极两种方法将虚拟触摸组织成像（VTI）添加到TI-RADS中，并探索哪种方法具有更好的诊断性能，哪种方法避免了更多不必要的活检。方法：从2016年1月到2021年12月，我们在这项回顾性研究中纳入了115名连续患者中的121个甲状腺结节，分类为TI-RADS 3-4类。本研究采用手术切除或活检的病理诊断参考标准。通过受试者工作特性（ROC）和ROC曲线下面积（AUC）来评估和比较不同方法的诊断性能。结果：在本研究中，在单独的TI-RADS、保守的方法和积极的方法中，积极的方法具有最好的诊断性能（AUC:0.863对0.598，P = 0.0007；0.863对0.755，P = 0.0067）。当我们使用积极的方法时，在TI-RADS诊断的57个假阳性淋巴结中，75.44%（43/57）从TI-RADS类别4适当降级为类别3，避免了不必要的活检。结论：VTI可提高TI-RADS的诊断性能。将TI-RADS与VTI相结合的积极方法将有助于减少不必要的活检。

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来源期刊

Clinical hemorheology and microcirculation 医学-外周血管病

CiteScore

4.30

自引率

33.30%

发文量

170

期刊介绍： Clinical Hemorheology and Microcirculation, a peer-reviewed international scientific journal, serves as an aid to understanding the flow properties of blood and the relationship to normal and abnormal physiology. The rapidly expanding science of hemorheology concerns blood, its components and the blood vessels with which blood interacts. It includes perihemorheology, i.e., the rheology of fluid and structures in the perivascular and interstitial spaces as well as the lymphatic system. The clinical aspects include pathogenesis, symptomatology and diagnostic methods, and the fields of prophylaxis and therapy in all branches of medicine and surgery, pharmacology and drug research. The endeavour of the Editors-in-Chief and publishers of Clinical Hemorheology and Microcirculation is to bring together contributions from those working in various fields related to blood flow all over the world. The editors of Clinical Hemorheology and Microcirculation are from those countries in Europe, Asia, Australia and America where appreciable work in clinical hemorheology and microcirculation is being carried out. Each editor takes responsibility to decide on the acceptance of a manuscript. He is required to have the manuscript appraised by two referees and may be one of them himself. The executive editorial office, to which the manuscripts have been submitted, is responsible for rapid handling of the reviewing process. Clinical Hemorheology and Microcirculation accepts original papers, brief communications, mini-reports and letters to the Editors-in-Chief. Review articles, providing general views and new insights into related subjects, are regularly invited by the Editors-in-Chief. Proceedings of international and national conferences on clinical hemorheology (in original form or as abstracts) complete the range of editorial features.