Concordance of the ACR TI-RADS Classification With Bethesda Scoring and Histopathology Risk Stratification of Thyroid Nodules

甲状腺结节 医学 组织病理学 一致性 放射科 甲状腺 贝塞斯达系统 甲状腺癌 细胞学 病理 内科学
作者
Erya Huang,Nern Hoong Kao,Snow Yunni Lin,Isabelle J. H. Jang,Kimberley L. Kiong,Anna See,Nanda Venkatanarasimha,Kristen Alexa Lee,Chwee Ming Lim
出处
期刊:JAMA network open [American Medical Association]
卷期号:6 (9): e2331612-e2331612 被引量:3
标识
DOI:10.1001/jamanetworkopen.2023.31612
摘要

Although most thyroid nodules are benign, 10% to 15% of them harbor cancer. Thyroid ultrasonography is useful for risk stratification of nodules, and American College of Radiology Thyroid Imaging Reporting and Data System (ACR TI-RADS) classification provides recommendations for fine-needle aspiration cytology (FNAC) based on objective ultrasonographic features of these nodules.To validate the concordance of ACR TI-RADS classification with Bethesda classification and histopathology.This retrospective cohort study was performed to evaluate the concordance of ACR TI-RADS classification with Bethesda classification and histopathology and was conducted in Singapore General Hospital Outpatient Otolaryngology clinic in March 2021 to May 2021. Data analysis was performed in May 2021.Results were deemed concordant when ACR TI-RADS recommendations aligned with Bethesda scores. Conversely, results were classified as nonconcordant with Bethesda scores and/or histopathology results when nodules that were recommended for FNAC yielded benign results or nodules that were not recommended for FNAC yielded malignant results.A total of 446 patients (370 women [83%]; mean [range] age, 60 [24-89] years) who underwent ultrasonography of the thyroid and ultrasonography-guided thyroid FNACs were identified. A total of 492 of 630 nodules (78.1%) were benign on FNAC (Bethesda II). Score 3 ACR TI-RADS nodules yielded the highest negative predictive values: 94.6% (95% CI, 92.9%-95.9%; P < .001) compared with Bethesda scoring and 100.0% (95% CI, 15.8%-100.0%; P = .003) compared with histopathology. Score 4 or 5 ACR TI-RADS nodules yielded positive predictive values of 2.8% and 16.2%, respectively, compared with Bethesda scoring and 6.1% and 66.7%, respectively, compared with histopathology. Small (<1.5 cm) ACR TI-RADS nodules of scores of 4 and 5 that were not recommended for FNAC yielded a malignant risk of 5.7% and 25.0% on Bethesda 5 and 6, respectively. On surgical excision, 5 of 46 (10.9%) ACR TI-RADS 4 nodules and 15 of 21 (71.4%) of ACR TI-RADS 5 nodules were confirmed to be malignant. Among nodules initially not recommended for FNAC, histopathology-proven cancer was found in 4 of 13 (30.7%) and 3 of 6 (50.0%) of nodules, respectively.These findings suggest that ACR TI-RADS score 3 nodules have a low risk of cancer and should be considered for FNAC only if nodules are 2.5 cm or larger. Patients with small (<1.5 cm) ACR TI-RADS 4 and 5 nodules should be appropriately counseled for FNAC to exclude cancer.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
大幅提高文件上传限制,最高150M (2024-4-1)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
Yuuuu完成签到 ,获得积分10
1秒前
jian94完成签到,获得积分10
1秒前
研友_nPxRRn完成签到,获得积分10
1秒前
娜na完成签到 ,获得积分10
4秒前
长安乱世完成签到 ,获得积分10
4秒前
哈哈哈完成签到,获得积分10
5秒前
honeyoko完成签到,获得积分10
6秒前
zyf完成签到,获得积分10
7秒前
科研通AI2S应助研友_LMBAXn采纳,获得10
7秒前
foyefeng完成签到,获得积分10
7秒前
祭途完成签到,获得积分10
8秒前
云辞忧完成签到,获得积分10
9秒前
时尚雨兰完成签到,获得积分10
12秒前
浅浅殇完成签到,获得积分10
12秒前
Ulrica完成签到,获得积分10
13秒前
于洋完成签到 ,获得积分10
14秒前
lihe198900完成签到 ,获得积分10
14秒前
18秒前
松柏完成签到 ,获得积分10
21秒前
努力向前看完成签到,获得积分10
22秒前
左丘白桃完成签到,获得积分10
24秒前
24秒前
koom完成签到,获得积分10
24秒前
guard发布了新的文献求助10
24秒前
40873完成签到,获得积分10
25秒前
徐慕源完成签到,获得积分10
25秒前
搭碰完成签到,获得积分0
26秒前
bulubulubulubule完成签到,获得积分20
26秒前
完美梨愁完成签到 ,获得积分10
27秒前
29秒前
无风完成签到 ,获得积分10
29秒前
tingalan完成签到,获得积分10
31秒前
吴大语完成签到,获得积分10
32秒前
彭于彦祖完成签到,获得积分0
34秒前
ylkk完成签到 ,获得积分10
35秒前
美满的小蘑菇完成签到 ,获得积分10
35秒前
Terahertz完成签到 ,获得积分10
37秒前
邬彤完成签到 ,获得积分10
38秒前
无风完成签到 ,获得积分10
43秒前
果粒橙128完成签到 ,获得积分10
44秒前
高分求助中
Sustainability in Tides Chemistry 2000
Microlepidoptera Palaearctica, Volumes 1 and 3 - 13 (12-Volume Set) [German] 1122
Дружба 友好报 (1957-1958) 1000
The Data Economy: Tools and Applications 1000
Mantiden - Faszinierende Lauerjäger – Buch gebraucht kaufen 700
PraxisRatgeber Mantiden., faszinierende Lauerjäger. – Buch gebraucht kaufe 700
A Dissection Guide & Atlas to the Rabbit 600
热门求助领域 (近24小时)
化学 医学 生物 材料科学 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 基因 遗传学 催化作用 物理化学 免疫学 量子力学 细胞生物学
热门帖子
关注 科研通微信公众号,转发送积分 3099819
求助须知:如何正确求助?哪些是违规求助? 2751306
关于积分的说明 7612410
捐赠科研通 2403104
什么是DOI,文献DOI怎么找? 1275188
科研通“疑难数据库(出版商)”最低求助积分说明 616276
版权声明 599053