A Review about C-TIRADS, ACR-TIRADS, and K-TIRADS Combined with Real-Time Tissue Elastography to Diagnose Thyroid Nodules.

IF 2 4区医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL Discovery medicine Pub Date : 2023-02-01 DOI:10.24976/Discov.Med.202335174.1

Yan Ma, Xiaoguang Huo, Shanshan Kong, Wenzhe Xu, Wei Zhao, Min Zhu

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引用次数: 1

Abstract

Purpose: This study aimed to evaluate the diagnostic efficiency of the Chinese version of thyroid imaging reporting and data system (C-TIRADS), American College of Radiology (ACR)-TIRADS, and Korean (K)-TIRADS combined with real-time tissue elastography to diagnose thyroid nodules.

Methods: A total of 574 thyroid nodule ultrasonographic images were retrospectively analyzed and classified based on the three TIRADS methods. The MedCale statistical software was used to construct the receiver operating characteristic (ROC) curve based on the pathological results of surgery. The diagnostic efficiency before and after assessing elastographies from the three TIRADS was compared between C-TIRADS, ACR-TIRADS, and K-TIRADS groups and within before and after TIRADS combined with elastic imaging. Furthermore, the unnecessary biopsy rates were also compared. Comparing area under ROC curve (AUC) with MEDCALC software (20.0.15, MedCalc Software Ltd., Ostend, Belgium), Delong test was used. The sensitivity and specificity were compared by STATA software (15.1, StataCorp LP, College Station, TX, USA) and Chi-square test. The rate of unnecessary biopsy was compared by SPSS software (23.0, IBM, Armonk, NY, USA) and Chi-square test.

Results: C-TIRADS, ACR-TIRADS, K-TIRADS cut-off values, and real-time tissue elastography (RTE) were 4b, 5, 5, and 3, respectively, and the areas under the ROC curve were 0.932, 0.914, 0.904, and 0.883, respectively. C-TIRADS had the highest AUC (p < 0.05) and sensitivity (p < 0.001), while ACR-TIRADS had the highest specificity (p < 0.001). After conducting a combined elastography with the three TIRADS, AUC showed increases of different degrees. Comparing TIRADS with TIRADS+RTE, the difference of C-TIRADS had statistical significance (p < 0.001), but the difference of ACR-TIRADS and K-TIRADS had no statistical significance (p > 0.05). The unnecessary biopsy rate showed decreases of different degrees. Differences between C-TIRADS and K-TIRADS were significant (p < 0.05), but in the case of ACR-TIRADS were not significant (p > 0.05).

Conclusions: C-TIRADS, ACR-TIRADS, K-TIRA and RTE showed high diagnostic efficiency, with C-TIRADS having the highest. Real-time tissue elastography can improve TIRADS diagnostic efficiency and reduce its unnecessary biopsy rate. In this case C-TIRADS showed again the highest efficiency.

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C-TIRADS、ACR-TIRADS、K-TIRADS联合实时组织弹性成像诊断甲状腺结节的研究进展。

目的:本研究旨在评价中国版甲状腺影像报告与数据系统(C-TIRADS)、美国放射学会(ACR)-TIRADS、韩国(K)-TIRADS联合实时组织弹性成像对甲状腺结节的诊断效果。方法:对574张甲状腺结节超声图像进行回顾性分析，并根据三种TIRADS方法进行分类。采用MedCale统计软件根据手术病理结果构建受试者工作特征(ROC)曲线。比较C-TIRADS、ACR-TIRADS和K-TIRADS三种TIRADS弹性成像评估前后的诊断效率，以及TIRADS联合弹性成像前后的诊断效率。此外，还比较了不必要的活检率。使用MEDCALC软件(20.0.15,MEDCALC software Ltd, Ostend, Belgium)比较ROC曲线下面积(AUC)，采用Delong检验。采用STATA软件(15.1,StataCorp LP, College Station, TX, USA)和卡方检验比较敏感性和特异性。采用SPSS软件(23.0,IBM, Armonk, NY, USA)和卡方检验比较不必要活检率。结果:C-TIRADS、ACR-TIRADS、K-TIRADS截止值和实时组织弹性成像(RTE)分别为4b、5,5和3,ROC曲线下面积分别为0.932、0.914、0.904和0.883。C-TIRADS的AUC最高(p < 0.05)，灵敏度最高(p < 0.001)，而ACR-TIRADS的特异性最高(p < 0.001)。三种TIRADS组合弹性成像后，AUC均有不同程度的增加。TIRADS与TIRADS+RTE比较，C-TIRADS差异有统计学意义(p < 0.001)，而ACR-TIRADS与K-TIRADS差异无统计学意义(p > 0.05)。不必要的活检率有不同程度的下降。C-TIRADS与K-TIRADS差异有统计学意义(p < 0.05)，而ACR-TIRADS差异无统计学意义(p > 0.05)。结论:C-TIRADS、ACR-TIRADS、K-TIRA、RTE诊断效率较高，其中C-TIRADS诊断效率最高。实时组织弹性成像可以提高TIRADS的诊断效率，减少不必要的活检率。在这种情况下，C-TIRADS再次显示出最高的效率。

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来源期刊

Discovery medicine MEDICINE, RESEARCH & EXPERIMENTAL-

CiteScore

5.40

自引率

0.00%

发文量

审稿时长

6-12 weeks

期刊介绍： Discovery Medicine publishes novel, provocative ideas and research findings that challenge conventional notions about disease mechanisms, diagnosis, treatment, or any of the life sciences subjects. It publishes cutting-edge, reliable, and authoritative information in all branches of life sciences but primarily in the following areas: Novel therapies and diagnostics (approved or experimental); innovative ideas, research technologies, and translational research that will give rise to the next generation of new drugs and therapies; breakthrough understanding of mechanism of disease, biology, and physiology; and commercialization of biomedical discoveries pertaining to the development of new drugs, therapies, medical devices, and research technology.