Thyroid imaging reporting and data system (TIRADS) for ultrasound features of nodules: multicentric retrospective study
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ORIGINAL ARTICLE
Thyroid imaging reporting and data system (TIRADS) for ultrasound features of nodules: multicentric retrospective study in China JianQiao Zhou1 YanYan Song2 WeiWei Zhan1 Xi Wei3 Sheng Zhang3 RuiFang Zhang4 Ying Gu5 Xia Chen5 Liying Shi5 XiaoMao Luo6 LiChun Yang6 QiaoYing Li7 BaoYan Bai8 XinHua Ye9 Hong Zhai10 Hua Zhang11 XiaoHong Jia1 YiJie Dong1 JingWen Zhang1 ZhiFang Yang1 HuiTing Zhang1 Yi Zheng1 WenWen Xu1 LiMei Lai1 LiXue Yin12 The Superficial Organ and Vascular Ultrasound Group of the Society of Ultrasound in Medicine of Chinese Medical Association The Chinese Artificial Intelligence Alliance for Thyroid and Breast Ultrasound ●
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Received: 4 February 2020 / Accepted: 28 July 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose To establish a practical and simplified Chinese thyroid imaging reporting and data system (C-TIRADS) based on the Chinese patient database. Methods A total of 2141 thyroid nodules that were neither cystic nor spongy were used in the current study. These specimens were derived from 2141 patients in 131 alliance hospitals of the Chinese Artificial Intelligence Alliance for Thyroid and Breast Ultrasound. The ultrasound features, including location, orientation, margin, halo, composition, echogenicity, echotexture, echogenic foci and posterior features were assessed. Univariate and multivariate analyses were performed to investigate the association between ultrasound features and malignancy. The regression equation, the weighting, and the counting methods were used to determine the malignant risk of the thyroid nodules. The areas under the receiver operating characteristic curve (Az values) were calculated. Results Of the 2141 thyroid nodules, 1572 were benign, 565 were malignant, and 4 were borderline. Vertical orientation, illdefined, or irregular margin (including extrathyroidal extension), microcalcifications, solid, and markedly hypoechoic were positively associated with malignancy, while comet-tail artifacts were negatively associated with malignancy. The logistic regression equation yielded the highest Az value of 0.913, which was significantly higher than that obtained using the weighting method (0.893) and the counting method (0.890); however, no significant difference was found between the latter two. The C-TIRADS, based on the counting method, was designed following the principle of balancing the diagnostic performance and sensitivity of the risk stratification with the ease of use. Conclusions A relatively simple C-TIRADS was established using the counting value of positive and negative ultrasound features. Keywords Thyroid nodule Diagnostic imaging Ultrasonography Risk assessment Biopsy Fine-needle ●
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Introduction Members of the Superficial Organ and Vascular Ultrasound Group of the Society of Ultrasound in Medicine of Chinese Medical Association and The Chinese Artificial Intelligence Alliance for Thyroid and Brea
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