Comparison of the diagnostic performance of the 2017 ACR TI-RADS guideline to the Kwak guideline in children with thyroid nodules.

Background: The Kwak Thyroid Imaging Reporting and Data System (Kwak-TI-RADS) guideline (2011) and American College of Radiology Thyroid Imaging Reporting and Data System (ACR TI-RADS) guideline (2017) were developed as ultrasound (US) risk stratification tools for detecting thyroid malignancy in ad...

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Publicado en:Pediatric Radiology Vol. 49; no. 7; pp. 862 - 869
Autores principales: Shapira-Zaltsberg, Gali, Miller, Elka, Martinez-Rios, Claudia, Bass, Juan, Goldbloom, Ellen B., Tang, Ken, Hayawi, Lamia, Highmore, Kerri
Formato: practice guidelines research Journal Article
Publicado: Springer Nature Jun2019
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Jun2019
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      pub: Springer Nature
      place: New York, New York
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        atl: Comparison of the diagnostic performance of the 2017 ACR TI-RADS guideline to the Kwak guideline in children with thyroid nodules.
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        au:
          Shapira-Zaltsberg, Gali
          Miller, Elka
          Martinez-Rios, Claudia
          Bass, Juan
          Goldbloom, Ellen B.
          Tang, Ken
          Hayawi, Lamia
          Highmore, Kerri
        affil: Department of Medical Imaging, CHEO, 401 Smyth Road, K1H 8L1, Ottawa, ON, Canada
      sug:
        subj:
          Ultrasonography Methods
          Thyroid Nodule
          Adolescence
          Child
          Human
          Reproducibility of Results
          Male
          Female
          Child, Preschool
          Retrospective Design
          Ontario
          Validation Studies
          Comparative Studies
          Evaluation Research
          Multicenter Studies
          Psychological Tests
          Scales
          Adolescent: 13-18 years
          Child: 6-12 years
          Child, Preschool: 2-5 years
          Male
          Female
      ab: Background: The Kwak Thyroid Imaging Reporting and Data System (Kwak-TI-RADS) guideline (2011) and American College of Radiology Thyroid Imaging Reporting and Data System (ACR TI-RADS) guideline (2017) were developed as ultrasound (US) risk stratification tools for detecting thyroid malignancy in adults.Objective: The purpose of this study was to investigate the inter-rater reliability and diagnostic performance of the ACR TI-RADS guideline in the pediatric population and compare it to the Kwak guideline.Materials and Methods: This retrospective study comprised 75 children who underwent thyroid US at a tertiary-level pediatric hospital. Three pediatric radiologists and one pediatric radiology fellow graded the US findings using the Kwak-TI-RADS and ACR TI-RADS guidelines. We assessed reliability of radiologists' ratings using percentage inter-rater agreement, and intra-class correlation coefficients (ICC2,1). We assessed area-under-the-receiver-operating-characteristic curve (AUROCC) to compare the discriminative diagnostic ability of the Kwak-TI-RADS and ACR TI-RADS scoring systems against histopathology/cytology, or stability on US over a 2-year follow-up period for cases without tissue diagnosis.Results: The inter-rater agreement was significantly better for the ACR TI-RADS level compared to the Kwak-TI-RADS level (P<0.001) using the percentage pairwise agreement. The ROC curves for assessing the diagnostic performance of the two methods showed no significant difference between the methods. The AUROCCs for the Kwak-TI-RADS and ACR TI-RADS levels were 0.74 (95% confidence interval [CI] 0.67-0.82) and 0.72 (95% CI 0.61-0.82), respectively.Conclusion: Both the Kwak-TI-RADS and ACR TI-RADS guidelines provide moderate malignancy risk stratification for thyroid nodules in the pediatric population, with better inter-rater agreement for the ACR TI-RADS guideline. Further work to adjust the recommendations for pediatric patients is necessary.
      pubtype: Academic Journal
      doctype:
        practice guidelines
        research
        Journal Article
      ougenre: Article
    language: English
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