Verification and comparisons of different ultrasound risk-stratification systems in the evaluation of thyroid nodules
10.3760/cma.j.issn.1004-4477.2018.12.008
- VernacularTitle:不同超声风险分层系统评估甲状腺结节的验证和对比研究
- Author:
Liqing JIANG
1
;
Ping ZHOU
;
Shuangming TIAN
;
Wengang LIU
;
Yongfeng ZHAO
;
Yan ZHANG
Author Information
1. 中南大学湘雅三医院超声科
- Keywords:
Ultrasonography;
Thyroid nodules;
Ultrasound risk-stratification system;
Receiver operating characteristic curve
- From:
Chinese Journal of Ultrasonography
2018;27(12):1048-1053
- CountryChina
- Language:Chinese
-
Abstract:
Objective To verify and compare the TI-RADS developed by Kwak et al .( Kwak TI-RADS ) ,2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer ( ATA Guideline Classification) ,2017 TI-RADS released by the American College of Radiology (ACR TI-RADS) and TI-RADS developed by Zhou et al .(Zhou TI-RADS) in the evaluation of thyroid nodules . Methods The ultrasound images of 339 thyroid nodules in 273 patients were analyzed by retrospective study . The thyroid nodules were categorized into aforementioned four stratified systems . Based on the pathological findings considered the "gold standard",the receiver operating characteristic( ROC ) curve was created to compare the clinical application value of aforementioned four stratified systems . Results The percentage of nodules that could not be categorized were 1 .2％ ,17 .5％ ,0 and 1 .2％ for the Kwak TI-RADS ,ATA guidelines ,ACR TI-RADS ,and Zhou TI-RADS ,respectively and the area under the ROC curve ( AUC) was 0 .899 ,0 .879 ,0 .876 ,and 0 .918 ,respectively . The sensitivity of Kwak TI-RADS ,ATA guidelines classification ,and ACR TI-RADS were higher than that of Zhou TI-RADS (all P < 0 .05) ,whereas the specificity of Zhou TI-RADS was the highest (all P < 0 .05) . As for the accuracy ,no statistically significant differences were observed between any two of Kwak TI-RADS ,ATA guidelines ,ACR TI-RADS ,and Zhou TI-RADS systems ( all P > 0 .05) . Conclusions Four thyroid risk stratification systems provide effective risk assessment for thyroid nodules ,Zhou TI-RADS has relatively lower sensitivity ,but its specificity and AUC value are the highest among the four evaluated systems . In addition ,ACR TI-RADS can classify the most nodules ,while the number of nodules that can′t be categorized by ATA guideline is maximum .
