Araştırma Makalesi
Yıl 2023,
Cilt: 30 Sayı: 3, 404 - 409, 23.09.2023
Öz
Objective
To investigate the diagnostic accuracy of the Thyroid
Imaging, Reporting and Data System of the American
College of Radiology in thyroid nodules.
Material and Method
A total of 151 nodules were collected from 62 patients
undergoing thyroid surgery in our center between
August 2017 and September 2018. Ultrasonographic
features of each nodule were recorded and classified
according to the Thyroid, Imaging Reporting and Data
System of the American College of Radiology by two
radiologists and compared with a one-to-one basis on
histopathology.
Results
The median size of 151 thyroid nodules measured on
the ultrasound and in the pathology specimens were
19 (3-85) mm and 17 (0-97) mm, respectively. Papillary
carcinoma was demonstrated in 28 patients (45%),
papillary microcarcinoma in 14 patients (22.5%), and
Hurthle cell carcinoma in 1 (1.6%) patient. Overall
sensitivity, specificity, positive predictive value,
and negative predictive value for this nodule risk
stratification model were analyzed as 82.5%, 57%,
64.58%, and 77.67%, respectively.
Conclusion
Setting a definitive size threshold for fine needle
aspiration might be misleading, instead signifying the
malignant features on ultrasonography, and making a
decision for surgery on an individual base should be
recommended.
Anahtar Kelimeler
Microcarcinoma Sensitivity Specificity Thyroid nodule TIRADS
Kaynakça
- 1. Gharib H, Papini E, Garber JR, Duick DS, Harrell RM, Hegedüs L, Paschke R, Valcavi R, Vitti P, AACE/ACE/AME Task Force on Thyroid Nodules. American Association of Clinical Endocrinologists, American College of Endocrinology, and Associazione Medici Endocrinologi Medical Guidelines For Clinical Practice for The Diagnosis and Management of Thyroid Nodules-2016 Update. Endocr Pract. 2016 May;22(5):622-39. doi: 10.4158/ EP161208.GL.
- 2. Zimmermann MB, Jooste PL, Pandav CS. Iodine-deficiency disorders. Lancet. 2008 Oct 4;372(9645):1251-62. doi: 10.1016/ S0140-6736(08)61005-3.
- 3. Grani G, Lamartina L, Biffoni M, Giacomelli L, Maranghi M, Falcone R, Ramundo V, Cantisani V, Filetti S, Durante C. Sonographically Estimated Risks of Malignancy for Thyroid Nodules Computed with Five Standard Classification Systems: Changes over Time and Their Relation to Malignancy. Thyroid. 2018 Sep;28(9):1190-1197. doi: 10.1089/thy.2018.0178.
- 4. Haugen BR, Alexander EK, Bible KC, Doherty GM, Mandel SJ, Nikiforov YE, Pacini F, Randolph GW, Sawka AM, Schlumber- ger M, Schuff KG, Sherman SI, Sosa JA, Steward DL, Tuttle RM, Wartofsky L. 2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer: The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer. Thyroid. 2016 Jan;26(1):1-133. doi: 10.1089/thy.2015.0020.
- 5. Horvath E, Silva CF, Majlis S, Rodriguez I, Skoknic V, Castro A, Rojas H, Niedmann JP, Madrid A, Capdeville F, Whittle C, Rossi R, Domínguez M, Tala H. Prospective validation of the ultrasound based TIRADS (Thyroid Imaging Reporting and Data System) classification: results in surgically resected thyroid nodules. Eur Radiol. 2017 Jun;27(6):2619-2628. doi: 10.1007/ s00330-016-4605-y.
- 6. Kwak JY, Han KH, Yoon JH, Moon HJ, Son EJ, Park SH, Jung HK, Choi JS, Kim BM, Kim EK. Thyroid imaging reporting and data system for US features of nodules: a step in establishing better stratification of cancer risk. Radiology. 2011 Sep;260(3):892-9. doi: 10.1148/radiol.11110206.
- 7. Moon WJ, Baek JH, Jung SL, Kim DW, Kim EK, Kim JY, Kwak JY, Lee JH, Lee JH, Lee YH, Na DG, Park JS, Park SW; Korean Society of Thyroid Radiology (KSThR); Korean Society of Radiology. Ultrasonography and the ultrasound-based management of thyroid nodules: consensus statement and recommendations. Korean J Radiol. 2011 Jan-Feb;12(1):1-14. doi: 10.3348/kjr.2011.12.1.1.
- 8. Qi Q, Zhou A, Guo S, Huang X, Chen S, Li Y, Xu P. Explore the Diagnostic Efficiency of Chinese Thyroid Imaging Reporting and Data Systems by Comparing with the Other Four Systems (ACR TI-RADS, Kwak-TIRADS, KSThR-TIRADS, and EU-TIRADS): A Single-Center Study. Front Endocrinol (Lausanne). 2021 Oct 27;12:763897. doi: 10.3389/fendo.2021.763897.
- 9. Gao L, Xi X, Jiang Y, Yang X, Wang Y, Zhu S, Lai X, Zhang X, Zhao R, Zhang B. Comparison among TIRADS (ACR TI-RADS and KWAK- TI-RADS) and 2015 ATA Guidelines in the diagnostic efficiency of thyroid nodules. Endocrine. 2019 Apr;64(1):90- 96. doi: 10.1007/s12020-019-01843-x.
- 10. Grant EG, Tessler FN, Hoang JK, Langer JE, Beland MD, Berland LL, Cronan JJ, Desser TS, Frates MC, Hamper UM, Middleton WD, Reading CC, Scoutt LM, Stavros AT, Teefey SA. Thyroid Ultrasound Reporting Lexicon: White Paper of the ACR Thyroid Imaging, Reporting and Data System (TIRADS) Committee. J Am Coll Radiol. 2015 Dec;12(12 Pt A):1272-9. doi: 10.1016/j.jacr.2015.07.011.
- 11. Grani G, Lamartina L, Ascoli V, Bosco D, Biffoni M, Giacomelli L, Maranghi M, Falcone R, Ramundo V, Cantisani V, Filetti S, Durante C. Reducing the Number of Unnecessary Thyroid Biopsies While Improving Diagnostic Accuracy: Toward the "Right" TIRADS. J Clin Endocrinol Metab. 2019 Jan 1;104(1):95- 102. doi: 10.1210/jc.2018-01674.
- 12. von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP, STROBE Initiative. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: guidelines for reporting observational studies. Int J Surg. 2014 Dec;12(12):1495-9. doi: 10.1016/j.ijsu.2014.07.013.
- 13. Park SJ, Park SH, Choi YJ, Kim DW, Son EJ, Lee HS, Yoon JH, Kim EK, Moon HJ, Kwak JY. Interobserver variability and diagnostic performance in US assessment of thyroid nodule according to size. Ultraschall Med. 2012 Dec;33(7):E186-E190. doi: 10.1055/s-0032-1325404.
- 14. Grani G, Lamartina L, Cantisani V, Maranghi M, Lucia P, Durante C. Interobserver agreement of various thyroid imaging reporting and data systems. Endocr Connect. 2018 Jan;7(1):1-7. doi: 10.1530/EC-17-0336.
- 15. Yoon SJ, Na DG, Gwon HY, Paik W, Kim WJ, Song JS, Shim MS. Similarities and Differences Between Thyroid Imaging Reporting and Data Systems. AJR Am J Roentgenol. 2019 Aug; 213(2):W76-W84. doi: 10.2214/AJR.18.20510.
- 16. Kim DH, Kim SW, Basurrah MA, Lee J, Hwang SH. Diagnostic Performance of Six Ultrasound Risk Stratification Systems for Thyroid Nodules: A Systematic Review and Network Meta-Analysis. AJR Am J Roentgenol. 2023 Jun;220(6):791-803. doi: 10.2214/AJR.22.28556.
- 17. Yang W, Fananapazir G, LaRoy J, Wilson M, Campbell MJ. Can the American Thyroid Association, K-Tirads, and Acr-Tirads Ultrasound Classification Systems Be Used to Predict Malignancy in Bethesda Category IV Nodules? Endocr Pract. 2020 Sep;26(9):945-952. doi: 10.4158/EP-2020-0024.
- 18. Hekimsoy İ, Öztürk E, Ertan Y, Orman MN, Kavukçu G, Özgen AG, Özdemir M, Özbek SS. Diagnostic performance rates of the ACR-TIRADS and EU-TIRADS based on histopathological evidence. Diagn Interv Radiol. 2021 Jul;27(4):511-518. doi: 10.5152/dir.2021.20813.
- 19. Xu T, Wu Y, Wu RX, Zhang YZ, Gu JY, Ye XH, Tang W, Xu SH, Liu C, Wu XH. Validation and comparison of three newly-released Thyroid Imaging Reporting and Data Systems for cancer risk determination. Endocrine. 2019 May;64(2):299-307. doi: 10.1007/s12020-018-1817-8.
- 20. Ha EJ, Na DG, Moon WJ, Lee YH, Choi N. Diagnostic Performance of Ultrasound-Based Risk-Stratification Systems for Thyroid Nodules: Comparison of the 2015 American Thyroid Association Guidelines with the 2016 Korean Thyroid Association/ Korean Society of Thyroid Radiology and 2017 American College of Radiology Guidelines. Thyroid. 2018 Nov;28(11):1532- 1537. doi: 10.1089/thy.2018.0094.
- 21. Koc AM, Adıbelli ZH, Erkul Z, Sahin Y, Dilek I. Comparison of diagnostic accuracy of ACR-TIRADS, American Thyroid Association (ATA), and EU-TIRADS guidelines in detecting thyroid malignancy. Eur J Radiol. 2020 Dec;133:109390. doi: 10.1016/j.ejrad.2020.109390.
- 22. Sugitani I, Toda K, Yamada K, Yamamoto N, Ikenaga M, Fujimoto Y. Three distinctly different kinds of papillary thyroid microcarcinoma should be recognized: our treatment strategies and outcomes. World J Surg. 2010 Jun;34(6):1222-31. doi: 10.1007/s00268-009-0359-x.
- 23. Ito Y, Miyauchi A, Kihara M, Higashiyama T, Kobayashi K, Miya A. Patient age is significantly related to the progression of papillary microcarcinoma of the thyroid under observation. Thyroid. 2014 Jan;24(1):27-34. doi: 10.1089/thy.2013.0367.
Yıl 2023,
Cilt: 30 Sayı: 3, 404 - 409, 23.09.2023
Öz
Amaç
Amerikan Radyoloji Koleji Tiroid Görüntüleme, Raporlama
ve Veri Sistemi’nin tanısal doğruluğunu araştırmak
Gereç ve Yöntem
Ağustos 2017 ve Eylül 2018 arasında merkezimizde
tiroid cerrahisi uygulanan 62 hastadan toplam 151 nodül
toplanmıştır. Her bir nodülün ultrasonografik özellikleri
iki radyolog tarafından kaydedilmiş ve Amerikan
Radyoloji Koleji Tiroid Görüntüleme, Raporlama ve
Veri Sistemi’ne göre sınıflanmış, ve histopatolojik olarak
birebir karşılaştırılmıştır.
Bulgular
151 tiroid nodül verisi ortanca boyutu ultrason ve patolojik
spesimenler üzerinde sırasıyla 19 (3-85) mm ve
17 (0-97) mm olarak ölçülmüştür. Papiller karsinom
28 hastada (%45), papiller mikrokarsinom 14 hastada
(%22.5), ve Hurthle hücreli karsinom 1 (%1.6) hastada
saptanmıştır. Bu nodül risk belirleme modeli için genel
sensitivite, spesifite, pozitif prediktif değer ve negatif
prediktif değer sırasıyla %82.5, %57, %64.58, ve
%77.67 olarak analiz edilmiştir.
Sonuç
İnce iğne aspirasyon biyopsisi için kesin bir boyut eşiği
belirlemek yanlış yönlendirici olabilir, bunun yerine ultrasonda
malign özelliklerin belirlenerek cerrahi kararın
kişi bazında verilmesi önerilmelidir.
Anahtar Kelimeler
Kaynakça
- 1. Gharib H, Papini E, Garber JR, Duick DS, Harrell RM, Hegedüs L, Paschke R, Valcavi R, Vitti P, AACE/ACE/AME Task Force on Thyroid Nodules. American Association of Clinical Endocrinologists, American College of Endocrinology, and Associazione Medici Endocrinologi Medical Guidelines For Clinical Practice for The Diagnosis and Management of Thyroid Nodules-2016 Update. Endocr Pract. 2016 May;22(5):622-39. doi: 10.4158/ EP161208.GL.
- 2. Zimmermann MB, Jooste PL, Pandav CS. Iodine-deficiency disorders. Lancet. 2008 Oct 4;372(9645):1251-62. doi: 10.1016/ S0140-6736(08)61005-3.
- 3. Grani G, Lamartina L, Biffoni M, Giacomelli L, Maranghi M, Falcone R, Ramundo V, Cantisani V, Filetti S, Durante C. Sonographically Estimated Risks of Malignancy for Thyroid Nodules Computed with Five Standard Classification Systems: Changes over Time and Their Relation to Malignancy. Thyroid. 2018 Sep;28(9):1190-1197. doi: 10.1089/thy.2018.0178.
- 4. Haugen BR, Alexander EK, Bible KC, Doherty GM, Mandel SJ, Nikiforov YE, Pacini F, Randolph GW, Sawka AM, Schlumber- ger M, Schuff KG, Sherman SI, Sosa JA, Steward DL, Tuttle RM, Wartofsky L. 2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer: The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer. Thyroid. 2016 Jan;26(1):1-133. doi: 10.1089/thy.2015.0020.
- 5. Horvath E, Silva CF, Majlis S, Rodriguez I, Skoknic V, Castro A, Rojas H, Niedmann JP, Madrid A, Capdeville F, Whittle C, Rossi R, Domínguez M, Tala H. Prospective validation of the ultrasound based TIRADS (Thyroid Imaging Reporting and Data System) classification: results in surgically resected thyroid nodules. Eur Radiol. 2017 Jun;27(6):2619-2628. doi: 10.1007/ s00330-016-4605-y.
- 6. Kwak JY, Han KH, Yoon JH, Moon HJ, Son EJ, Park SH, Jung HK, Choi JS, Kim BM, Kim EK. Thyroid imaging reporting and data system for US features of nodules: a step in establishing better stratification of cancer risk. Radiology. 2011 Sep;260(3):892-9. doi: 10.1148/radiol.11110206.
- 7. Moon WJ, Baek JH, Jung SL, Kim DW, Kim EK, Kim JY, Kwak JY, Lee JH, Lee JH, Lee YH, Na DG, Park JS, Park SW; Korean Society of Thyroid Radiology (KSThR); Korean Society of Radiology. Ultrasonography and the ultrasound-based management of thyroid nodules: consensus statement and recommendations. Korean J Radiol. 2011 Jan-Feb;12(1):1-14. doi: 10.3348/kjr.2011.12.1.1.
- 8. Qi Q, Zhou A, Guo S, Huang X, Chen S, Li Y, Xu P. Explore the Diagnostic Efficiency of Chinese Thyroid Imaging Reporting and Data Systems by Comparing with the Other Four Systems (ACR TI-RADS, Kwak-TIRADS, KSThR-TIRADS, and EU-TIRADS): A Single-Center Study. Front Endocrinol (Lausanne). 2021 Oct 27;12:763897. doi: 10.3389/fendo.2021.763897.
- 9. Gao L, Xi X, Jiang Y, Yang X, Wang Y, Zhu S, Lai X, Zhang X, Zhao R, Zhang B. Comparison among TIRADS (ACR TI-RADS and KWAK- TI-RADS) and 2015 ATA Guidelines in the diagnostic efficiency of thyroid nodules. Endocrine. 2019 Apr;64(1):90- 96. doi: 10.1007/s12020-019-01843-x.
- 10. Grant EG, Tessler FN, Hoang JK, Langer JE, Beland MD, Berland LL, Cronan JJ, Desser TS, Frates MC, Hamper UM, Middleton WD, Reading CC, Scoutt LM, Stavros AT, Teefey SA. Thyroid Ultrasound Reporting Lexicon: White Paper of the ACR Thyroid Imaging, Reporting and Data System (TIRADS) Committee. J Am Coll Radiol. 2015 Dec;12(12 Pt A):1272-9. doi: 10.1016/j.jacr.2015.07.011.
- 11. Grani G, Lamartina L, Ascoli V, Bosco D, Biffoni M, Giacomelli L, Maranghi M, Falcone R, Ramundo V, Cantisani V, Filetti S, Durante C. Reducing the Number of Unnecessary Thyroid Biopsies While Improving Diagnostic Accuracy: Toward the "Right" TIRADS. J Clin Endocrinol Metab. 2019 Jan 1;104(1):95- 102. doi: 10.1210/jc.2018-01674.
- 12. von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP, STROBE Initiative. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: guidelines for reporting observational studies. Int J Surg. 2014 Dec;12(12):1495-9. doi: 10.1016/j.ijsu.2014.07.013.
- 13. Park SJ, Park SH, Choi YJ, Kim DW, Son EJ, Lee HS, Yoon JH, Kim EK, Moon HJ, Kwak JY. Interobserver variability and diagnostic performance in US assessment of thyroid nodule according to size. Ultraschall Med. 2012 Dec;33(7):E186-E190. doi: 10.1055/s-0032-1325404.
- 14. Grani G, Lamartina L, Cantisani V, Maranghi M, Lucia P, Durante C. Interobserver agreement of various thyroid imaging reporting and data systems. Endocr Connect. 2018 Jan;7(1):1-7. doi: 10.1530/EC-17-0336.
- 15. Yoon SJ, Na DG, Gwon HY, Paik W, Kim WJ, Song JS, Shim MS. Similarities and Differences Between Thyroid Imaging Reporting and Data Systems. AJR Am J Roentgenol. 2019 Aug; 213(2):W76-W84. doi: 10.2214/AJR.18.20510.
- 16. Kim DH, Kim SW, Basurrah MA, Lee J, Hwang SH. Diagnostic Performance of Six Ultrasound Risk Stratification Systems for Thyroid Nodules: A Systematic Review and Network Meta-Analysis. AJR Am J Roentgenol. 2023 Jun;220(6):791-803. doi: 10.2214/AJR.22.28556.
- 17. Yang W, Fananapazir G, LaRoy J, Wilson M, Campbell MJ. Can the American Thyroid Association, K-Tirads, and Acr-Tirads Ultrasound Classification Systems Be Used to Predict Malignancy in Bethesda Category IV Nodules? Endocr Pract. 2020 Sep;26(9):945-952. doi: 10.4158/EP-2020-0024.
- 18. Hekimsoy İ, Öztürk E, Ertan Y, Orman MN, Kavukçu G, Özgen AG, Özdemir M, Özbek SS. Diagnostic performance rates of the ACR-TIRADS and EU-TIRADS based on histopathological evidence. Diagn Interv Radiol. 2021 Jul;27(4):511-518. doi: 10.5152/dir.2021.20813.
- 19. Xu T, Wu Y, Wu RX, Zhang YZ, Gu JY, Ye XH, Tang W, Xu SH, Liu C, Wu XH. Validation and comparison of three newly-released Thyroid Imaging Reporting and Data Systems for cancer risk determination. Endocrine. 2019 May;64(2):299-307. doi: 10.1007/s12020-018-1817-8.
- 20. Ha EJ, Na DG, Moon WJ, Lee YH, Choi N. Diagnostic Performance of Ultrasound-Based Risk-Stratification Systems for Thyroid Nodules: Comparison of the 2015 American Thyroid Association Guidelines with the 2016 Korean Thyroid Association/ Korean Society of Thyroid Radiology and 2017 American College of Radiology Guidelines. Thyroid. 2018 Nov;28(11):1532- 1537. doi: 10.1089/thy.2018.0094.
- 21. Koc AM, Adıbelli ZH, Erkul Z, Sahin Y, Dilek I. Comparison of diagnostic accuracy of ACR-TIRADS, American Thyroid Association (ATA), and EU-TIRADS guidelines in detecting thyroid malignancy. Eur J Radiol. 2020 Dec;133:109390. doi: 10.1016/j.ejrad.2020.109390.
- 22. Sugitani I, Toda K, Yamada K, Yamamoto N, Ikenaga M, Fujimoto Y. Three distinctly different kinds of papillary thyroid microcarcinoma should be recognized: our treatment strategies and outcomes. World J Surg. 2010 Jun;34(6):1222-31. doi: 10.1007/s00268-009-0359-x.
- 23. Ito Y, Miyauchi A, Kihara M, Higashiyama T, Kobayashi K, Miya A. Patient age is significantly related to the progression of papillary microcarcinoma of the thyroid under observation. Thyroid. 2014 Jan;24(1):27-34. doi: 10.1089/thy.2013.0367.
Toplam 23 adet kaynakça vardır.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Cerrahi |
| Bölüm | Araştırma Makaleleri |
| Yazarlar | |
| Yayımlanma Tarihi | 23 Eylül 2023 |
| Gönderilme Tarihi | 29 Mayıs 2023 |
| Kabul Tarihi | 6 Eylül 2023 |
| Yayımlandığı Sayı | Yıl 2023 Cilt: 30 Sayı: 3 |
Süleyman Demirel Üniversitesi Tıp Fakültesi Dergisi/Medical Journal of Süleyman Demirel University is licensed under Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International.