Comparative analysis of the diagnostic efficiency of the four thyroid imaging reporting and data systems

Jun Xu , Wei-Bing Zhang , Wen-Fang Deng , Bei-Li He , Ting-Yue Qi
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Abstract

The purpose of this study was to comparative analyze the diagnostic efficiency of Thyroid Imaging Reporting and Data System proposed by Kwak, American College of Radiology, the European Thyroid Association and the Chinese Medical Association, respectively (Kwak TI-RADS, ACR TI-RADS, EU-TIRADS and C-TIRADS, respectively) for malignant risk stratification of thyroid nodules. A total of 1142 thyroid nodules confirmed by cytological or surgical pathologies were retrospectively classified according to Kwak TI-RADS, ACR TI-RADS, EU-TIRADS and C-TIRADS. The area under the receiver operating characteristic curve (AUC), the diagnostic sensitivity, specificity, Youden index, and accuracy of each TI-RADS for nodules was calculated and compared. The diagnostic sensitivity of ACR TI-RADS was 85.5%, which was lowest (all P < 0.05). The diagnostic specificity of ACR TI-RADS was higher than that of Kwak TI-RADS and EU-TIRADS (all P < 0.05), but there was no significant difference compared with that of C-TIRADS (x2 = 2.335, P = 0.126). The diagnostic accuracies of the four methods were more than 85%, and there were no significant differences (all P > 0.05). The AUC of C-TIRADS was highest among the four methods (all P < 0.05). The four methods have high diagnostic efficiency in malignant risk stratification of thyroid nodules, and the AUC of C-TIRADS was higher than that of the other three methods.

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四种甲状腺成像报告和数据系统诊断效率的比较分析
本研究旨在比较分析分别由 Kwak、美国放射学会、欧洲甲状腺协会和中华医学会提出的甲状腺影像报告和数据系统(Kwak TI-RADS、ACR TI-RADS、EU-TIRADS 和 C-TIRADS)对甲状腺结节恶性风险分层的诊断效率。根据 Kwak TI-RADS、ACR TI-RADS、EU-TIRADS 和 C-TIRADS 对经细胞学或手术病理证实的 1142 个甲状腺结节进行了回顾性分类。计算并比较了接受者操作特征曲线下面积(AUC)、每种 TI-RADS 对结节的诊断敏感性、特异性、尤登指数和准确性。ACR TI-RADS 的诊断灵敏度为 85.5%,最低(均为 P < 0.05)。ACR TI-RADS 的诊断特异性高于 Kwak TI-RADS 和 EU-TIRADS(均为 P < 0.05),但与 C-TIRADS 相比无显著差异(x2 = 2.335,P = 0.126)。四种方法的诊断准确率均超过 85%,且无明显差异(均为 P > 0.05)。四种方法中 C-TIRADS 的 AUC 最高(均为 P < 0.05)。四种方法对甲状腺结节恶性风险分层的诊断效率较高,其中C-TIRADS的AUC高于其他三种方法。
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