Diagnostic performance rates of the ACR-TIRADS and EU-TIRADS based on histopathological evidence

Özet

PURPOSEIn this study, we aimed to assess the effectiveness of malignancy stratification algorithms of theAmerican College of Radiology (ACR) and European Thyroid Association (ETA) in the delineationof thyroid nodules using a database of nodules that were unequivocally diagnosed by means ofhistopathological examination and meticulously matched with the imaged nodules.METHODSA total of 165 patients having 251 thyroid nodules with histopathologically proven definitivediagnoses during a 5-year period were included in this study. All patients had preoperativelyundergone ultrasonography (US) examination, and US characteristics of the thyroid noduleswere retrospectively analyzed and assigned in compliance with the thyroid imaging reportingand data system categories recommended by the ACR (ACR-TIRADS) and ETA (EU-TIRADS). Thediagnostic effectiveness in the delineation of thyroid nodules and unnecessary fine-needle aspiration (FNAB) rates were evaluated.RESULTSOverall, 189 nodules (75.30%) were diagnosed as benign, while 62 nodules (24.70%) were reported to be malignant based on histopathological assessment. Sensitivity and specificity rateswere 71% and 75% for ACR-TIRADS and 73% and 80% for EU-TIRADS. The area under the curvevalues were 0.78 and 0.80 for ACR-TIRADS and EU-TIRADS, respectively. The unnecessary FNABrates were 61% for ACR-TIRADS and 64% for EU-TIRADS as per the recommended criteria of eachalgorithm.CONCLUSIONThe diagnostic performance of both malignancy stratification systems was signified to be moderate and sufficient in a cohort of nodules with definite histopathological diagnosis. In light ofour results, we demonstrated the strengths and weaknesses of the ACR- and EU-TIRADS for physicians who should be familiar with them for optimal management of thyroid nodules.