Diagnostic Performance of Different Thyroid Imaging Reporting and Data Systems (Kwak-TIRADS, EU-TIRADS and ACR TI-RADS) for Risk Stratification of Small Thyroid Nodules (≤10 mm)

Simone Schenke; Rigobert Klett; Philipp Seifert; Michael C Kreissl; Rainer Görges; Michael Zimny

doi:10.3390/jcm9010236

Diagnostic Performance of Different Thyroid Imaging Reporting and Data Systems (Kwak-TIRADS, EU-TIRADS and ACR TI-RADS) for Risk Stratification of Small Thyroid Nodules (≤10 mm)

J Clin Med. 2020 Jan 16;9(1):236. doi: 10.3390/jcm9010236.

Authors

Simone Schenke^{1

2}, Rigobert Klett², Philipp Seifert³, Michael C Kreissl¹, Rainer Görges⁴, Michael Zimny²

Affiliations

¹ Division of Nuclear Medicine, Department of Radiology and Nuclear Medicine, Magdeburg University Hospital, Leipziger Straße 44, 39120 Magdeburg, Germany.
² Institute for Nuclear Medicine Hanau/Giessen/Offenbach/Frankfurt, Paul-Zipp-Straße 171, 35398 Gießen, Germany.
³ Clinic of Nuclear Medicine, Jena University Hospital, Am Klinikum 1 A4U1, 07740 Jena Lobeda-Ost, Germany.
⁴ Department of Nuclear Medicine, Essen University Hospital, Hufelandstraße 55, 45122 Essen, Germany.

Abstract

Due to the widespread use of ultrasound, small thyroid nodules (TNs) ≤ 10 mm are common findings. Standardized approaches for the risk stratification of TNs with Thyroid Imaging Reporting and Data Systems (TIRADS) were evaluated for the clinical routine. With TIRADS, the risk of malignancy in TNs is calculated by scoring the number or combination of suspicious ultrasound features, leading to recommendations for further diagnostic steps. However, there are only scarce data on the performance of TIRADS for small TNs. The aim was to compare three different TIRADS for risk stratification of small TNs in routine clinical practice. We conducted a retrospective cohort analysis of TNs ≤ 10 mm and their available histology. Nodules were classified according to three different TIRADS. In the study, 140 patients (n = 113 female) with 145 thyroid nodules (n = 76 malignant) were included. Most of the malignant nodules were papillary carcinoma (97%), and the remaining 3% were medullary carcinoma. For all tested TIRADS, the prevalence of malignancy rose with increasing category levels. The highest negative predictive value was found for ACR TI-RADS and the highest positive predictive value for Kwak-TIRADS. All tested variants of TIRADS showed comparable diagnostic performance for the risk stratification of small TNs. TIRADS seems to be a promising tool to reliably assess the risk of malignancy of small TNs.

Keywords: TIRADS; risk stratification; small thyroid nodules; thyroid carcinomas.