Correlation of ACR TI-RADS and Patient Outcomes in a Real-World Cohort Presenting for Thyroid Ultrasonography.
Context The American College of Radiology Thyroid Image Reporting and Data System (ACR TI-RADS) was developed to predict malignancy risk in thyroid nodules using ultrasound features. TI-RADS was derived from a database of patients already selected for fine-needle aspiration (FNA), raising uncertaint...
| Publicado en: | Journal of the Endocrine Society Vol. 7; no. 10; pp. 1 - 7 |
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| Autores principales: | , , , , , , , |
| Formato: | Journal Article |
| Publicado: |
Oxford University Press / USA
Oct2023
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=172896113&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 172896113 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 24721972 LBOG jtl: Journal of the Endocrine Society issn: 24721972 maglogo: N pubinfo: dt: Oct2023 vid: 7 iid: 10 pid: 622 pub: Oxford University Press / USA artinfo: ui: 172896113 10.1210/jendso/bvad119 172896113 ppf: 1 ppct: 6 formats: tig: atl: Correlation of ACR TI-RADS and Patient Outcomes in a Real-World Cohort Presenting for Thyroid Ultrasonography. aug: au: Wilkinson, Tom Cawood, Tom Lim, Anthony Roche, David Jiang, Jasmine Thomson, Ben Marais, Michelle Hunt, Penny affil: Department of Endocrinology, Te Whatu Ora/Health New Zealand Waitaha/Canterbury , Christchurch 8011 , New Zealand sug: ab: Context The American College of Radiology Thyroid Image Reporting and Data System (ACR TI-RADS) was developed to predict malignancy risk in thyroid nodules using ultrasound features. TI-RADS was derived from a database of patients already selected for fine-needle aspiration (FNA), raising uncertainty about applicability to unselected patients. Objective We aimed to assess the effect of ACR TI-RADS reporting in unselected patients presenting for thyroid ultrasound in a real-world setting. Methods Records for all patients presenting for thyroid ultrasonography in Canterbury, New Zealand, were reviewed across two 18-month periods, prior to and after implementation of TI-RADS reporting. Patient outcomes were compared between the 2 periods. Malignancy rates were calculated for nodules 10 mm or larger with a definitive FNA or histology result. Results A total of 1210 nodules were identified in 582 patients prior to implementation of TI-RADS; 1253 nodules were identified in 625 patients after implementation of TI-RADS. TI-RADS category was associated with malignancy rate (0% in TR1 and TR2, 3% in TR3, 5% in TR4, 12% in TR5; P =.02); however, 63% of nodules were graded TR3 or TR4, for which malignancy rate did not meaningfully differ from baseline risk. After implementation of TI-RADS there was a small reduction in the proportion of patients proceeding to FNA (49% vs 60%; P <.01) or surgery (14% vs 18%; P <.05), with no difference in cancer diagnoses (3% vs 4%, not significant). Conclusion TI-RADS category is associated with malignancy rate and may alter clinical decision-making in a minority of patients; however, it is nondiscriminatory in the majority of nodules. In this study of unselected patients, nodules classified as TR5 and thus considered "highly suspicious" for cancer had only a modest risk of malignancy. pubtype: Academic Journal doctype: Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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