open access

Vol 69, No 2 (2018)
Original paper
Submitted: 2017-07-24
Accepted: 2017-11-17
Published online: 2018-01-12
Get Citation

Evaluation of Four Variants of the Thyroid Imaging Reporting and Data System (TIRADS) Classification in Patients with Multinodular Goitre — initial study

Bartosz Migda1, Michal Migda2, Anna M. Migda3, Jacek Bierca4, Jadwiga Slowniska-Srzednicka5, Wieslaw Jakubowski1, Rafal Z. Slapa1
·
Pubmed: 29334119
·
Endokrynol Pol 2018;69(2):156-162.
Affiliations
  1. Department of Diagnostic Imaging, Second Faculty of Medicine with the English Division and the Physiotherapy Division, Medical University of Warsaw, Warsaw, Poland
  2. United District Hospital, Collegium Medicum, University of Nicolaus Copernicus, Clinical Unit of Obstetrics, Women’s Disease and Gynecological Oncology, Torun, Poland
  3. First Department of Internal Diseases, Bielanski Hospital, Warsaw, Poland
  4. Surgery Department, Solec Hospital, Warsaw, Poland
  5. Department of Endocrinology, Centre for Postgraduate Medical Education, Warsaw, Poland

open access

Vol 69, No 2 (2018)
Original Paper
Submitted: 2017-07-24
Accepted: 2017-11-17
Published online: 2018-01-12

Abstract

Purpose The goal this study was to evaluate the utility of four variants of the Thyroid Imaging Reporting and Data System (TIRADS) in the differentiation of focal lesions in individuals with multinodular goiter.   Materials and Methods The study was approved by the Local Bioethical Committee. Each patient gave informed consent before enrolment. A total of 163 nodules in 124 patients with multinodular goiter were evaluated by ultrasound. B-mode and PD imaging and strain elastography were performed. Archived images were evaluated via retrospective analysis using four different proposed TIRADS classifications   Results Sensitivity and specificity of the Horvath, Park, Kwak, and Russ classifications were 0.625 and 0.769, 0.813 and 0.864, 0.938 and 0.667, and 0.875 and 0.293, respectively. Positive and negative predictive values were 0.227 and 0.95, 0.394 and 0.977, 0.234 and 0.99, and 0.119 and 0.956, respectively. Receive operating characteristic analysis suggests that the best differentiation potential was demonstrated by the Kwak classification with an area under the curve (AUC) of 0.896, followed by the Park (AUC = 0.872), Horvath (AUC = 0.774), and Russ (AUC = 0.729) classifications.   Conclusion The TIRADS classification proposed by Kwak can be a useful tool in daily practice for the evaluation of thyroid cancer in individuals with multinodular goiter, particularly for selecting cases that require biopsy, which may improve and simplify clinical decision making. To adopt a definitive, comprehensive variant of the TIRADS classification with potential for universal, practical application, further prospective studies that include improvement of the lexicon and evaluation of the full spectrum of thyroid malignancy are warranted.

Abstract

Purpose The goal this study was to evaluate the utility of four variants of the Thyroid Imaging Reporting and Data System (TIRADS) in the differentiation of focal lesions in individuals with multinodular goiter.   Materials and Methods The study was approved by the Local Bioethical Committee. Each patient gave informed consent before enrolment. A total of 163 nodules in 124 patients with multinodular goiter were evaluated by ultrasound. B-mode and PD imaging and strain elastography were performed. Archived images were evaluated via retrospective analysis using four different proposed TIRADS classifications   Results Sensitivity and specificity of the Horvath, Park, Kwak, and Russ classifications were 0.625 and 0.769, 0.813 and 0.864, 0.938 and 0.667, and 0.875 and 0.293, respectively. Positive and negative predictive values were 0.227 and 0.95, 0.394 and 0.977, 0.234 and 0.99, and 0.119 and 0.956, respectively. Receive operating characteristic analysis suggests that the best differentiation potential was demonstrated by the Kwak classification with an area under the curve (AUC) of 0.896, followed by the Park (AUC = 0.872), Horvath (AUC = 0.774), and Russ (AUC = 0.729) classifications.   Conclusion The TIRADS classification proposed by Kwak can be a useful tool in daily practice for the evaluation of thyroid cancer in individuals with multinodular goiter, particularly for selecting cases that require biopsy, which may improve and simplify clinical decision making. To adopt a definitive, comprehensive variant of the TIRADS classification with potential for universal, practical application, further prospective studies that include improvement of the lexicon and evaluation of the full spectrum of thyroid malignancy are warranted.
Get Citation

Keywords

thyroid, nodular goitre, ultrasound, elastography, thyroid imaging reporting and data system

Supp./Additional Files (1)
Title Page PL
Download
B
About this article
Title

Evaluation of Four Variants of the Thyroid Imaging Reporting and Data System (TIRADS) Classification in Patients with Multinodular Goitre — initial study

Journal

Endokrynologia Polska

Issue

Vol 69, No 2 (2018)

Article type

Original paper

Pages

156-162

Published online

2018-01-12

Page views

3066

Article views/downloads

1760

DOI

10.5603/EP.a2018.0012

Pubmed

29334119

Bibliographic record

Endokrynol Pol 2018;69(2):156-162.

Keywords

thyroid
nodular goitre
ultrasound
elastography
thyroid imaging reporting and data system

Authors

Bartosz Migda
Michal Migda
Anna M. Migda
Jacek Bierca
Jadwiga Slowniska-Srzednicka
Wieslaw Jakubowski
Rafal Z. Slapa

References (32)
  1. Fagin JA, Mitsiades N. Molecular pathology of thyroid cancer: diagnostic and clinical implications. Best Pract Res Clin Endocrinol Metab. 2008; 22(6): 955–969.
  2. Koike E, Noguchi S, Yamashita H, et al. Ultrasonographic characteristics of thyroid nodules: prediction of malignancy. Arch Surg. 2001; 136(3): 334–337.
  3. Papini E, Guglielmi R, Bianchini A, et al. Risk of malignancy in nonpalpable thyroid nodules: predictive value of ultrasound and color-Doppler features. J Clin Endocrinol Metab. 2002; 87(5): 1941–1946.
  4. Horvath E, Majlis S, Rossi R, et al. An ultrasonogram reporting system for thyroid nodules stratifying cancer risk for clinical management. J Clin Endocrinol Metab. 2009; 94(5): 1748–1751.
  5. Park JY, Lee HJ, Jang HW, et al. A proposal for a thyroid imaging reporting and data system for ultrasound features of thyroid carcinoma. Thyroid. 2009; 19(11): 1257–1264.
  6. D’Orsi CJ, Sickles EA, Mendelson EB, Morris EA, al eA. ACR BI-RADS® Atlas, Breast Imaging Reporting and Data System. In: Radiology ACo. Reston, VA, Reston, VA 2013.
  7. Kwak JY, Han KH, Yoon JH, et al. Thyroid imaging reporting and data system for US features of nodules: a step in establishing better stratification of cancer risk. Radiology. 2011; 260(3): 892–899.
  8. Russ G, Royer B, Bigorgne C, et al. Prospective evaluation of thyroid imaging reporting and data system on 4550 nodules with and without elastography. Eur J Endocrinol. 2013; 168(5): 649–655.
  9. Cheng SP, Lee JJ, Lin JL, et al. Characterization of thyroid nodules using the proposed thyroid imaging reporting and data system (TI-RADS). Head Neck. 2013; 35(4): 541–547.
  10. Friedrich-Rust M, Meyer G, Dauth N, et al. Interobserver agreement of Thyroid Imaging Reporting and Data System (TIRADS) and strain elastography for the assessment of thyroid nodules. PLoS One. 2013; 8(10): e77927.
  11. Choi YJ, Baek JH, Baek SH, et al. Web-Based Malignancy Risk Estimation for Thyroid Nodules Using Ultrasonography Characteristics: Development and Validation of a Predictive Model. Thyroid. 2015; 25(12): 1306–1312.
  12. Maia FFR, Matos PS, Pavin EJ, et al. Thyroid imaging reporting and data system score combined with Bethesda system for malignancy risk stratification in thyroid nodules with indeterminate results on cytology. Clin Endocrinol (Oxf). 2015; 82(3): 439–444.
  13. Zhang J, Liu BJ, Xu HX, et al. Prospective validation of an ultrasound-based thyroid imaging reporting and data system (TI-RADS) on 3980 thyroid nodules. Int J Clin Exp Med. 2015; 8(4): 5911–5917.
  14. Park VY, Kim EK, Kwak JY, et al. Thyroid Imaging Reporting and Data System and Ultrasound Elastography: Diagnostic Accuracy as a Tool in Recommending Repeat Fine-Needle Aspiration for Solid Thyroid Nodules with Non-Diagnostic Fine-Needle Aspiration Cytology. Ultrasound Med Biol. 2016; 42(2): 399–406.
  15. Migda B, Słapa R, Bierca J, et al. Differentiation of thyroid nodules in multinodular goiter with the application of technical ultrasound advances - initial results. Endokrynol Pol. 2016; 67(2): 157–165.
  16. Kim EK, Park CS, Chung WY, et al. New sonographic criteria for recommending fine-needle aspiration biopsy of nonpalpable solid nodules of the thyroid. AJR Am J Roentgenol. 2002; 178(3): 687–691.
  17. Chan BK, Desser TS, McDougall IR, et al. Common and uncommon sonographic features of papillary thyroid carcinoma. J Ultrasound Med. 2003; 22(10): 1083–1090.
  18. Jarzab B, Dedecjus M, Słowińska-Klencka D, et al. Guidelines of Polish National Societies Diagnostics and Treatment of Thyroid Carcinoma. 2018 Update. Endokrynol Pol. 2018; 69(1): 34–74.
  19. Bartolotta TV, Midiri M, Galia M, et al. Qualitative and quantitative evaluation of solitary thyroid nodules with contrast-enhanced ultrasound: initial results. Eur Radiol. 2006; 16(10): 2234–2241.
  20. Nemec U, Nemec SF, Novotny C, et al. Quantitative evaluation of contrast-enhanced ultrasound after intravenous administration of a microbubble contrast agent for differentiation of benign and malignant thyroid nodules: assessment of diagnostic accuracy. Eur Radiol. 2012; 22(6): 1357–1365.
  21. Dobruch-Sobczak K, Zalewska EB, Gumińska A, et al. Diagnostic Performance of Shear Wave Elastography Parameters Alone and in Combination with Conventional B-Mode Ultrasound Parameters for the Characterization of Thyroid Nodules: A Prospective, Dual-Center Study. Ultrasound Med Biol. 2016; 42(12): 2803–2811.
  22. Cantisani V, Lodise P, Di Rocco G, et al. Diagnostic accuracy and interobserver agreement of Quasistatic Ultrasound Elastography in the diagnosis of thyroid nodules. Ultraschall Med. 2015; 36(2): 162–167.
  23. Bista M, K C T, Regmi D, et al. Diagnostic accuracy of fine needle aspiration cytology in thyroid swellings. J Nepal Health Res Counc. 2011; 9(1): 14–16.
  24. Moon HJ, Sung JiM, Kim EK, et al. Diagnostic performance of gray-scale US and elastography in solid thyroid nodules. Radiology. 2012; 262(3): 1002–1013.
  25. Unlütürk U, Erdoğan MF, Demir O, et al. Ultrasound elastography is not superior to grayscale ultrasound in predicting malignancy in thyroid nodules. Thyroid. 2012; 22(10): 1031–1038.
  26. Bojunga J, Herrmann E, Meyer G, et al. Real-time elastography for the differentiation of benign and malignant thyroid nodules: a meta-analysis. Thyroid. 2010; 20(10): 1145–1150.
  27. Cantisani V, D'Andrea V, Biancari F, et al. Prospective evaluation of multiparametric ultrasound and quantitative elastosonography in the differential diagnosis of benign and malignant thyroid nodules: preliminary experience. Eur J Radiol. 2012; 81(10): 2678–2683.
  28. Gietka-Czernel M, Kochman M, Bujalska K, et al. Real-time ultrasound elastography - a new tool for diagnosing thyroid nodules. Endokrynol Pol. 2010; 61(6): 652–657.
  29. Woliński K, Szczepanek-Parulska E, Stangierski A, et al. How to select nodules for fine-needle aspiration biopsy in multinodular goitre. Role of conventional ultrasonography and shear wave elastography - a preliminary study. Endokrynol Pol. 2014; 65(2): 114–118.
  30. Grant EG, Tessler FN, Hoang JK, et al. Thyroid Ultrasound Reporting Lexicon: White Paper of the ACR Thyroid Imaging, Reporting and Data System (TIRADS) Committee. J Am Coll Radiol. 2015; 12(12 Pt A): 1272–1279.
  31. Trzebińska A, Dobruch-Sobczak K, Jakubowski W, et al. Standards of the Polish Ultrasound Society - update. Ultrasound examination of thyroid gland and ultrasound-guided thyroid biopsy. J Ultrason. 2014; 14(56): 49–60.
  32. Ferris RL, Baloch Z, Bernet V, et al. American Thyroid Association Surgical Affairs Committee. American Thyroid Association Statement on Surgical Application of Molecular Profiling for Thyroid Nodules: Current Impact on Perioperative Decision Making. Thyroid. 2015; 25(7): 760–768.

Regulations

Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

Via MedicaWydawcą jest  VM Media Group sp. z o.o., Grupa Via Medica, ul. Świętokrzyska 73, 80–180 Gdańsk

tel.:+48 58 320 94 94, faks:+48 58 320 94 60, e-mail:  viamedica@viamedica.pl