Diagnostic Value of TI-RADS Classification System and Next Generation Genetic Sequencing in Indeterminate Thyroid Nodules.

Rationale and Objectives: This study aims to evaluate the diagnostic accuracy, inter-reader, and intra-reader variability of the ACR Thyroid Imaging Reporting and Data System (TI-RADS) for risk-stratification of indeterminate thyroid nodules using next generation genetic sequencing and tissue histol...

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Publicado en:Academic Radiology Vol. 28; no. 12; pp. 1685 - 1692
Autores principales: Daniels, Kelly E., Xu, Jiajun, Liu, Ji-Bin, Chen, Xiangmei, Huang, Kun, Patel, Jena, Cottrill, Elizabeth, Eisenbrey, John R., Lyshchik, Andrej
Formato: research Journal Article
Publicado: Elsevier B.V. Dec2021
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Dec2021
      vid: 28
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      pub: Elsevier B.V.
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        NLM32839097
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        10.1016/j.acra.2020.07.037
        NLM32839097
        153581338
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        atl: Diagnostic Value of TI-RADS Classification System and Next Generation Genetic Sequencing in Indeterminate Thyroid Nodules.
      aug:
        au:
          Daniels, Kelly E.
          Xu, Jiajun
          Liu, Ji-Bin
          Chen, Xiangmei
          Huang, Kun
          Patel, Jena
          Cottrill, Elizabeth
          Eisenbrey, John R.
          Lyshchik, Andrej
        affil: Thomas Jefferson University, Department of Otolaryngology – Head & Neck Surgery, Philadelphia Pennsylvania
      sug:
        subj:
          Thyroid Nodule
          Retrospective Design
          Female
          Middle Age
          Adult
          Aged
          Ultrasonography
          Reproducibility of Results
          Arthritis Impact Measurement Scales
          Psychological Tests
          Human
          Middle Aged: 45-64 years
          Adult: 19-44 years
          Aged: 65+ years
          Female
      ab: Rationale and Objectives: This study aims to evaluate the diagnostic accuracy, inter-reader, and intra-reader variability of the ACR Thyroid Imaging Reporting and Data System (TI-RADS) for risk-stratification of indeterminate thyroid nodules using next generation genetic sequencing and tissue histology as a reference standard.Materials and Methods: Retrospective chart review was performed on all patients who underwent thyroid ultrasound for a nodule with subsequent fine-needle aspiration ± surgical resection from January 2017 to August 2018. Four radiologists with expertise in thyroid ultrasound assessed imaging twice, ≥1 month apart. Results of cytology and next generation genetic sequencing were used as a reference standard for high versus low risk of malignancy in each nodule. Inter-reader reliability between readers and intra-reader reliability between replicate self-reads for TI-RADS categorization were assessed. Univariate analysis, kappa statistics, and receiver operating characteristic curve were calculated.Results: One hundred and thirty six nodules across 121 patients met inclusion criteria. 84.6% of patients were female and average age was 55.8 ± 14.1 years. One hundred and eighteen of 135 nodules (87%) had indeterminate cytology (Bethesda III or IV). One of 23 high-risk mutations was identified in 30.1% (42) of the nodules. Of the 52 patients who had surgery, 24 (47.1%) had confirmed malignant disease on surgical pathology. Inter-reader reliability between the four radiologists was marginal, κ = 0.293. Intra-reader reliability ranged from marginal to good, κ = 0.337 to κ = 0.560, respectively. The area under the receiver operating characteristic curve was 0.509, and no optimal TI-RADS Level for identifying high-risk nodules existed.Conclusion: The ACR TI-RADS classification system performs with low inter-reader and intra-reader reliability when assessing the genetic risk of nodules with indeterminate cytology.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
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