Accuracy of ultrasound in predicting thyroid malignancy: a comparative analysis of the ACR TI-RADS and ATA risk stratification systems.

IF 1.6 4区 医学 Q4 ENDOCRINOLOGY & METABOLISM Archives of Endocrinology Metabolism Pub Date : 2024-04-26 eCollection Date: 2024-01-01 DOI:10.20945/2359-4292-2023-0245
Shaza Samargandy, Aliaa H Ghoneim
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Abstract

Objective: Thyroid nodules are very common in clinical practice, and ultrasound has long been used as a screening tool for their evaluation. Several risk assessment systems based on ultrasonography have been developed to stratify the risk of malignancy and determine the need for fine-needle aspiration in thyroid nodules, including the American Thyroid Association (ATA) system and the American College of Radiology Thyroid Imaging Reporting and Data System (ACR TI-RADS). The aim of this study was to compare the performance of the ATA and ACR TI-RADS systems in predicting malignancy in thyroid nodules based on the nodules' final histopathology reports.

Materials and methods: We performed a retrospective review of medical records to identify patients who underwent thyroid surgery at King Abdulaziz University from 2017 to 2022. The ultrasound features of the nodules with confirmed histopathology (benign versus malignant) were evaluated. Both ATA and ACR TI-RADS scores were documented.

Results: The analysis included 191 patients who underwent thyroid surgery and fulfilled the inclusion criteria. Hemithyroidectomy was performed in 22.5% of the patients, and total thyroidectomy was performed in 77.0% of them. In all, 91 patients (47.6%) were found to have malignant nodules on histopathology. We then compared the histopathology reports with the preoperative ultrasonographic risk scores. The estimated sensitivity and specificity in identifying malignant nodules were, respectively, 52% and 80% with the ATA system and 51.6% and 90% with the ACR TI-RADS system.

Conclusion: Both ATA and ACR TI-RADS risk stratification systems are valuable tools for assessing the malignancy risk in thyroid nodules. In our study, the ACR TI-RADS system had superior specificity compared with the ATA system in predicting malignancy among high-risk lesions.

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超声波预测甲状腺恶性肿瘤的准确性:ACR TI-RADS 和 ATA 风险分层系统的比较分析。
目的:甲状腺结节在临床实践中非常常见,长期以来,超声一直被用作评估甲状腺结节的筛查工具。目前已开发出几种基于超声造影的风险评估系统,包括美国甲状腺协会(ATA)系统和美国放射学会甲状腺成像报告和数据系统(ACR TI-RADS),用于对甲状腺结节的恶性风险进行分层并确定是否需要进行细针穿刺。本研究旨在比较 ATA 和 ACR TI-RADS 系统根据结节最终组织病理学报告预测甲状腺结节恶性程度的性能:我们对病历进行了回顾性审查,以确定2017年至2022年期间在阿卜杜勒-阿齐兹国王大学接受甲状腺手术的患者。评估了组织病理学确诊结节的超声特征(良性与恶性)。ATA和ACR TI-RADS评分均有记录:分析包括191名接受甲状腺手术且符合纳入标准的患者。22.5%的患者接受了半甲状腺切除术,77.0%的患者接受了全甲状腺切除术。经组织病理学检查,共有91名患者(47.6%)被发现患有恶性结节。然后,我们将组织病理学报告与术前超声风险评分进行了比较。ATA系统识别恶性结节的灵敏度和特异度分别为52%和80%,ACR TI-RADS系统为51.6%和90%:结论:ATA和ACR TI-RADS风险分层系统都是评估甲状腺结节恶性风险的重要工具。在我们的研究中,与ATA系统相比,ACR TI-RADS系统在预测高风险病变的恶性程度方面具有更高的特异性。
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来源期刊
Archives of Endocrinology Metabolism
Archives of Endocrinology Metabolism Medicine-Endocrinology, Diabetes and Metabolism
CiteScore
2.90
自引率
5.90%
发文量
107
审稿时长
7 weeks
期刊介绍: The Archives of Endocrinology and Metabolism - AE&M – is the official journal of the Brazilian Society of Endocrinology and Metabolism - SBEM, which is affiliated with the Brazilian Medical Association. Edited since 1951, the AE&M aims at publishing articles on scientific themes in the basic translational and clinical area of Endocrinology and Metabolism. The printed version AE&M is published in 6 issues/year. The full electronic issue is open access in the SciELO - Scientific Electronic Library Online e at the AE&M site: www.aem-sbem.com. From volume 59 on, the name was changed to Archives of Endocrinology and Metabolism, and it became mandatory for manuscripts to be submitted in English for the online issue. However, for the printed issue it is still optional for the articles to be sent in English or Portuguese. The journal is published six times a year, with one issue every two months.
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