Efficiency comparison of Kwak and ACR (2017) Thyroid Imaging Reporting and Data System(TI-RADS) classification: a polycentric retrospective study
Liang Yu, Yue Linxian, Chen Qin, Lin Jie, Guo Daoning, He Peng, Yang Fang, Yue Wensheng, Zheng Hong, Ruan Jiaquan, Liu Haijun, Song Jianqiong, Yang Lingying, Wang Juan, Zhou Chengting, Wu Yutian, Wang Siyi, Tang Yanqiong, Yuan Mengxia, Zhao Yan
Abstract
ObjectiveTo evaluate the diagnostic efficacy of Kwak and ACR(2017) thyroid imaging reporting and data systems(TI-RADS) for thyroid nodules.
MethodsCases of thyroid nodule who underwent surgery from January 2015 to March 2018 in 15 hospitals in Sichuan province were collected and the ultrasonographic features of thyroid nodules were retrospectively analyzed by trained senior ultrasound physicians using Kwak and ACR TI-RADS classification methods. Totally, 12 712 thyroid nodules were observed, 7 023 thyroid nodules in 7 023 cases with complete ultrasound and surgical and pathological data were eventually enrolled in the study. Thyroid nodules with solid, hypoechoic or very hypoechoic, tall/wide ratio ≥1, margin ill-defined and microcalcification were classified as malignant signs of ultrasound. Malignant percentage was calculated and diagnostic tests were performed.
Results①There was a statistical difference between the benign and malignant nodules in the two types of TI-RADS classification (P<0.01). ②The area under ROC curve of Kwak and ACR in the diagnosis of malignant nodules were 0.89 and 0.84, respectively. The Youden index of Kwak and ACR were 0.66 and 0.57, respectively. ③Taking Kwak TI4B and ACR TR4 as critical points for malignancy, the sensitivity, specificity, positive predictive value and negative predictive value of Kwak TI4B were 75.0%, 90.9%, 83.2%, and 85.9%, respectively. The accuracy of Kwak TI4B was 84.9%; The sensitivity, specificity, positive predictive value and negative predictive value of ACR TR4 were 88.2%, 68.9%, 62.9%, and 90.8%, respectively. The accuracy of ACR TR4 was 76.2%. The Kappa value of Kwak TI4B and ACR TR4 was 0.52. The χ2 value of Kwak TI4B and ACR TR4 was 2 174.6 (P<0.01).
ConclusionsThe diagnostic values of two TI-RADS classification methods for thyroid malignant nodules are high. The overall efficiency of Kwak TI-RADS classification method is better than that of ACR TI-RADS classification method.
Key words:
Ultrasonography; Thyroid nodule; Thyroid imaging reporting and data system; Kwak TI-RADS; ACR TI-RADS; Diagnostic efficiency
Contributor Information
Liang Yu
Department of Ultrasound, Sichuan Provincial People′s Hospital, Chengdu 610072, China
Yue Linxian
Department of Ultrasound, Sichuan Provincial People′s Hospital, Chengdu 610072, China
Chen Qin
Department of Ultrasound, Sichuan Provincial People′s Hospital, Chengdu 610072, China
Lin Jie
Department of Ultrasound, Mianyang Central Hospital, Mianyang 621000, China
Guo Daoning
Department of Ultrasound, Mianyang Central Hospital, Mianyang 621000, China
He Peng
Department of Ultrasound, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, China
Yang Fang
Department of Ultrasound, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, China
Yue Wensheng
Department of Ultrasound, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, China
Zheng Hong
Department of Ultrasound, People′s Hospital of Deyang City, Deyang 618000, China
Ruan Jiaquan
Department of Ultrasound, Yibin Second People′s Hospital, Yibin 644000, China
Liu Haijun
Department of Ultrasound, Suining Central Hospital, Suining 629000, China
Song Jianqiong
Department of Ultrasound, Dazhou Central Hospital, Dazhou 635000, China
Yang Lingying
Department of Ultrasound, Jianyang People′s Hospital, Jianyang 641400, China
Wang Juan
Department of Ultrasound, Third People′s Hospital of Chengdu, Chengdu 610031, China
Zhou Chengting
Department of Ultrasound, First People′s Hospital of Chengdu, Chengdu 610000, China
Wu Yutian
Department of Ultrasound, Fifth People′s Hospital of Chengdu, Chengdu 611130, China
Wang Siyi
Department of Ultrasound, Chengdu Military General Hospital, Chengdu 610083, China
Tang Yanqiong
Department of Ultrasound, Chongzhou People′s Hospital, Chongzhou 611230, China
Yuan Mengxia
Department of Ultrasound, Second People′s Hospital of Chengdu, Chengdu 610000, China
Zhao Yan
Department of Ultrasound, Panzhihua Central Hospital, Panzhihua 617000, China
