Prospective validation of the ultrasound based TIRADS (Thyroid Imaging Reporting And Data System) classification: results in surgically resected thyroid nodules

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dc.contributor.authorHorvath, Eleonora
dc.contributor.authorSilva, Claudio
dc.contributor.authorMajlis, Sergio
dc.contributor.authorRodriguez, Ignacio
dc.contributor.authorSkoknic, Velimir
dc.contributor.authorCastro, Alex
dc.contributor.authorRojas, Hugo
dc.contributor.authorNiedmann, Juan Pablo
dc.contributor.authorMadrid, Arturo
dc.contributor.authorCapdeville, Felipe
dc.contributor.authorWhittle, Carolina
dc.contributor.authorRossi, Ricardo
dc.contributor.authorDominguez, Miguel
dc.contributor.authorTala, Hernán
dc.date.accessioned2017-08-08T20:05:26Z
dc.date.available2017-08-08T20:05:26Z
dc.date.issued2017
dc.description.abstractOBJECTIVE: To assess performance of TIRADS classification on a prospective surgical cohort, demonstrating its clinical usefulness. METHODS: Between June 2009 and October 2012, patients assessed with pre-operative ultrasound (US) were included in this IRB-approved study. Nodules were categorised according to our previously described TIRADS classification. Final pathological diagnosis was obtained from the thyroidectomy specimen. Sensitivity, specificity, positive/negative predictive values and likelihood ratios were calculated. RESULTS: The study included 210 patients with 502 nodules (average: 2.39 (±1.64) nodules/patient). Median size was 7 mm (3-60 mm). Malignancy was 0 % (0/116) in TIRADS 2, 1.79 % (1/56) in TIRADS 3, 76.13 % (185/243) in TIRADS 4 [subgroups: TIRADS 4A 5.88 % (1/17), TIRADS 4B 62.82 % (49/78), TIRADS 4C 91.22 % (135/148)], and 98.85 % (86/87) in TIRADS 5. With a cut-off point at TIRADS 4-5 to perform FNAB, we obtained: sensitivity 99.6 % (95 % CI: 98.9-100.0), specificity 74.35 % (95 % CI: 68.7-80.0), PPV 82.1 % (95 % CI: 78.0-86.3), NPV 99.4 % (95 % CI: 98.3-100.0), PLR 3.9 (95 % CI: 3.6-4.2) and an NLR 0.005 (95 % CI: 0.003-0.04) for malignancy. CONCLUSION: US-based TIRADS classification allows selection of nodules requiring FNAB and recognition of those with a low malignancy risk. KEY POINTS: • TIRADS classification allows accurate selection of thyroid nodules requiring biopsy (TIRADS 4-5). • The recognition of benign/possibly benign patterns can avoid unnecessary procedures. • This classification and its sonographic patterns are validated using surgical specimens.
dc.description.versionVersión Publicada
dc.format.extent10
dc.identifier.citationHorvath, E., Silva, C.F., Majlis, S. et al. Prospective validation of the ultrasound based TIRADS (Thyroid Imaging Reporting And Data System) classification: results in surgically resected thyroid nodules. Eur Radiol 27, 2619–2628 (2017). https://doi.org/10.1007/s00330-016-4605-y
dc.identifier.urihttp://hdl.handle.net/11447/1542
dc.identifier.urihttp://dx.doi.org/10.1007/s00330-016-4605
dc.language.isoen_US
dc.publisherSpringer
dc.sourceEuropean Radiology
dc.subjectRisk classification
dc.subjectThyroid cancer
dc.subjectThyroid neoplasm
dc.subjectThyroid nodule
dc.subjectUltrasound
dc.titleProspective validation of the ultrasound based TIRADS (Thyroid Imaging Reporting And Data System) classification: results in surgically resected thyroid nodules
dc.typeArtículo

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