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Vol 69, No 2 (2018)
Original paper
Submitted: 2017-07-24
Accepted: 2017-11-17
Published online: 2018-01-12
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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
DOI: 10.5603/EP.a2018.0012
·
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.

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Keywords

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

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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

2808

Article views/downloads

1620

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

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