Objective: Bethesda System for Reporting Thyroid Cytopathology(BSRTC) categories Ⅰ, Ⅲ, and Ⅴaccount for a significant proportion of fine needle aspiration cytology(FNAC) diagnoses. This study aimed to compare the d...Objective: Bethesda System for Reporting Thyroid Cytopathology(BSRTC) categories Ⅰ, Ⅲ, and Ⅴaccount for a significant proportion of fine needle aspiration cytology(FNAC) diagnoses. This study aimed to compare the diagnostic efficacy of BRAF^(V600E) mutation and the Thyroid Imaging Reporting and Data System(TIRADS) classification in differentiating papillary thyroid cancers(PTCs) from benign lesions among BSRTC I, III, and V nodules.Methods: A total of 472 patients with 479 nodules were enrolled in this prospective study. Ultrasound, BRAF^(V600E) mutation testing, and FNAC were performed in each nodule, followed by surgery or regular ultrasound examination.Results: In the BSRTC I category, BRAF^(V600E) showed similar sensitivity, higher specificity, and lower accuracy when compared with TIRADS. In the BSRTC III/V category, the sensitivity, specificity, and accuracy of BRAF^(V600E) were similar to those of TIRADS. In comparison to BRAF^(V600E) alone, the combination of the two methods significantly improved sensitivity(BSRTC Ⅰ:93.6% vs. 67.7%, P < 0.01; BSRTC Ⅲ: 93.8% vs. 75.0%, P < 0.01; BSRTC V: 96.0% vs. 85.3%, P < 0.001). When compared with TIRADS alone, the combination improved sensitivity in BSRTC Ⅰ nodules(93.6% vs. 74.2%, P < 0.05), increased sensitivity and decreased accuracy in BSRTC III nodules(93.8% vs. 75.0%, P < 0.01, 91.0% vs. 93.6%, P < 0.01), and improved both sensitivity and accuracy in BSRTC V nodules(96.0% vs. 82.0%, P < 0.001; 94.2% vs. 81.3%, P < 0.001).Conclusions: BRAF^(V600E) exhibited higher specificity and lower accuracy compared with TIRADS in BSRTC Ⅰ nodules, while the two methods showed similar diagnostic value in BSRTC Ⅲ/Ⅴ nodules. The combination of the two methods distinctly improved sensitivity in the diagnosis of PTCs in BSRTC Ⅰ, Ⅲ, and Ⅴ nodules.展开更多
Background: Ultrasonography (US) is the best diagnostic tool in the initial assessment of thyroid nodule. Giving its appropriateness and accessibility, ultrasound-based thyroid imaging reporting and data systems (TIRA...Background: Ultrasonography (US) is the best diagnostic tool in the initial assessment of thyroid nodule. Giving its appropriateness and accessibility, ultrasound-based thyroid imaging reporting and data systems (TIRADS) classifications have been developed with main goal to standardize reporting and facilitate communication between practitioners, and to indicate when fine-needle aspiration biopsy (FNAB) should be performed. Objective: To determine the reliability of Russ’ modified TIRADS classification in predicting thyroid malignancy. Materials and Methods: It was a cross sectional study carried out at Centre Hospitalier de Lagny, Marne La Vallée (France). Consecutive records of patients with focal thyroid nodules on ultrasound (US) for which US-guided FNAB was performed and pathology results were available, from January 2007 to August 2012, were selected for review. The risk of malignancy of each TIRADS category was determined and correlation with pathology assessed. Statistical performances of some US features were also assessed. The threshold for statistical significance was set at 0.05. Results: A total of 430 records of patients were eligible. Twenty-three out of 430 (5.3%) nodules were malignant. The risk of malignancy of the TIRADS categories were as follows: TIRADS2 0%, TIRADS3 2.2%, TIRADS4A 5.9%, TIRADS4B 57.9%, TIRADS5 100% (Gamma statistic = 0.85;Spearman correlation = 0.30, Pearson’s R = 0.37, p Conclusion: Russ’ modified TIRADS classification is reliable in predicting thyroid malignancy. More evidence is nevertheless necessary for widespread adoption and use.展开更多
Objective To compare the diagnostic efficiency of the thyroid imaging reporting and data system(TIRADS),the Bethesda system for reporting thyroid cytopathology(BSRTC)and BRAFV600Edetection,and their combined use in th...Objective To compare the diagnostic efficiency of the thyroid imaging reporting and data system(TIRADS),the Bethesda system for reporting thyroid cytopathology(BSRTC)and BRAFV600Edetection,and their combined use in the differentiation between benign and malignant thyroid nodules.Methods One hundred展开更多
目的:探讨超声造影前后能否提高甲状腺影像报告和数据系统(thyroid image report and data system,TIRADS)诊断效能。方法:选择2017年12月至2019年5月行甲状腺超声结节造影的患者151例,共152个结节,分析152个结节造影前后的二维声像特...目的:探讨超声造影前后能否提高甲状腺影像报告和数据系统(thyroid image report and data system,TIRADS)诊断效能。方法:选择2017年12月至2019年5月行甲状腺超声结节造影的患者151例,共152个结节,分析152个结节造影前后的二维声像特征差异,比较造影前后TI-RADS分级诊断、造影过程联合造影后TI-RADS的诊断效能。结果:造影前及造影后二维声像图上甲状腺结节边缘、钙化有统计学差异(P<0.05),回声类型无统计学差异(P>0.05)。造影前后TI-RADS分级诊断的敏感性、特异性、准确率分别为83.51%、45.45%、69.73%和96.91%、40.00%、76.32%。造影过程联合造影后TI-RADS分级的敏感性、特异性、准确率分别为83.51%、63.64%、76.32%。造影后TI-RADS、造影过程联合造影后TI-RADS的受试者工作特征曲线下面积均高于造影前(P<0.05)。结论:超声造影技术能提高二维声像图甲状腺结节边缘、钙化特征判读的准确性,造影后TI-RADS分级具有更高的敏感性,造影过程联合造影后TI-RADS具有更高的特异性,超声造影技术能够提高TI-RADS分级的诊断效能。展开更多
<strong>Context: </strong>Diagnostic imaging has increased the rate of thyroid nodules detection and improved utilization of fine-needle aspiration (FNA). <strong>Objective:</strong> This study...<strong>Context: </strong>Diagnostic imaging has increased the rate of thyroid nodules detection and improved utilization of fine-needle aspiration (FNA). <strong>Objective:</strong> This study aims to demonstrate the effects of the most reliable non-invasive technique on thyroid nodules. <strong>Methods:</strong> Between 2016 and 2020, 190 patients with 214 nodules visiting King Khalid University Hospital were randomly selected and retrospectively reviewed. Following the ACR TI-RADS recommendations for FNA and correlating cytology reports. Two expert radiologists with ultrasonographic imaging experience re-evaluated and reviewed the images. 88 nodules (41%) in 79 patients were excluded because the nodule size was smaller than the FNA recommended size. <strong>Results:</strong> Following the ACR TI-RADS for FNA recommended selection, 27 nodules (21.4%) out of the recommended 126 nodules were consistent with malignancy in cytology, with overall mean sensitivities, specificities, accuracies, precisions, and negative predictive values (NPV) of 96.4%, 40.7%, 48.7%, 28.4%, and 98.6% respectively. The nodules were subdivided into the TI-RADS 3, 4, and 5.<strong> Conclusion:</strong> In conclusion, ACR TI-RADS is feasible, reliable, and well structured, easily applicable in thyroid nodules reporting. ACR TI-RADS can eliminate many unnecessary FNAs, providing a decline in costs and complications. We recommend the ACR TI-RADS in our radiology department to eliminate reporting discrepancies and cut costs, thereby standardizing the reports, improving intra-user agreements, and improving overall patients’ health care.展开更多
Background: The Canadian province of Saskatchewan introduced a pre-fine needle aspiration (FNA) clinic to review adherence of referrals for thyroid biopsy based on the guidelines of the American College of Radiology’...Background: The Canadian province of Saskatchewan introduced a pre-fine needle aspiration (FNA) clinic to review adherence of referrals for thyroid biopsy based on the guidelines of the American College of Radiology’s (ACR) Thyroid Imaging, Reporting and Data System (TI-RADS) scoring system. The intention is to minimize low-yield biopsy rates by improving the quality of thyroid nodule investigation in Saskatchewan through this clinic. TI-RADS is a malignancy risk scoring system for thyroid nodules based on five sonographic characteristics: composition, echogenicity, shape, margin, and echogenic foci (calcium). Recommendations for intervention or clinical follow-up are further determined by the size of the nodule. Methods: Through a retrospective chart review of all thyroid biopsy referrals to the Royal University Hospital (RUH) in Saskatchewan between 22 March 2016 and 17 May 2018, the impact of the multidisciplinary pre-FNA clinic on appropriate thyroid biopsies in Saskatchewan was evaluated. Results: This study evaluated 252 referrals, 203 of which underwent FNA and 23 which received surgical biopsy. TI-RADS scores appended to thyroid biopsy referrals increased upon pre-FNA clinic initiation, yet score quality did not improve. Rates of malignant biopsies were lower than ACR-reporting suggesting inappropriate biopsy of low risk nodules perhaps by overcalling the TI-RADS score. The majority of FNA cytology matched final surgical pathology, with 78% of indeterminate FNAs being malignant, and all non-diagnostic FNAs being benign. Conclusions: The implementation of the pre-FNA clinic reduced the number of thyroid biopsies in Saskatchewan by 11% overall.展开更多
基金supported by grants from the National Natural Science Foundation of China (Grant No. 81261120566)Jiangsu Province Key Medical Personnel Project (Grant No. RC2011068)+2 种基金333 Projects in the Fourth Phase of Jiangsu Province (Grant No. BRA2015389)Jiangsu Province "Six First Project" Research Program (Grant No. LGY2016004)the Priority Academic Program Development of Jiangsu Higher Education Institutions
文摘Objective: Bethesda System for Reporting Thyroid Cytopathology(BSRTC) categories Ⅰ, Ⅲ, and Ⅴaccount for a significant proportion of fine needle aspiration cytology(FNAC) diagnoses. This study aimed to compare the diagnostic efficacy of BRAF^(V600E) mutation and the Thyroid Imaging Reporting and Data System(TIRADS) classification in differentiating papillary thyroid cancers(PTCs) from benign lesions among BSRTC I, III, and V nodules.Methods: A total of 472 patients with 479 nodules were enrolled in this prospective study. Ultrasound, BRAF^(V600E) mutation testing, and FNAC were performed in each nodule, followed by surgery or regular ultrasound examination.Results: In the BSRTC I category, BRAF^(V600E) showed similar sensitivity, higher specificity, and lower accuracy when compared with TIRADS. In the BSRTC III/V category, the sensitivity, specificity, and accuracy of BRAF^(V600E) were similar to those of TIRADS. In comparison to BRAF^(V600E) alone, the combination of the two methods significantly improved sensitivity(BSRTC Ⅰ:93.6% vs. 67.7%, P < 0.01; BSRTC Ⅲ: 93.8% vs. 75.0%, P < 0.01; BSRTC V: 96.0% vs. 85.3%, P < 0.001). When compared with TIRADS alone, the combination improved sensitivity in BSRTC Ⅰ nodules(93.6% vs. 74.2%, P < 0.05), increased sensitivity and decreased accuracy in BSRTC III nodules(93.8% vs. 75.0%, P < 0.01, 91.0% vs. 93.6%, P < 0.01), and improved both sensitivity and accuracy in BSRTC V nodules(96.0% vs. 82.0%, P < 0.001; 94.2% vs. 81.3%, P < 0.001).Conclusions: BRAF^(V600E) exhibited higher specificity and lower accuracy compared with TIRADS in BSRTC Ⅰ nodules, while the two methods showed similar diagnostic value in BSRTC Ⅲ/Ⅴ nodules. The combination of the two methods distinctly improved sensitivity in the diagnosis of PTCs in BSRTC Ⅰ, Ⅲ, and Ⅴ nodules.
文摘Background: Ultrasonography (US) is the best diagnostic tool in the initial assessment of thyroid nodule. Giving its appropriateness and accessibility, ultrasound-based thyroid imaging reporting and data systems (TIRADS) classifications have been developed with main goal to standardize reporting and facilitate communication between practitioners, and to indicate when fine-needle aspiration biopsy (FNAB) should be performed. Objective: To determine the reliability of Russ’ modified TIRADS classification in predicting thyroid malignancy. Materials and Methods: It was a cross sectional study carried out at Centre Hospitalier de Lagny, Marne La Vallée (France). Consecutive records of patients with focal thyroid nodules on ultrasound (US) for which US-guided FNAB was performed and pathology results were available, from January 2007 to August 2012, were selected for review. The risk of malignancy of each TIRADS category was determined and correlation with pathology assessed. Statistical performances of some US features were also assessed. The threshold for statistical significance was set at 0.05. Results: A total of 430 records of patients were eligible. Twenty-three out of 430 (5.3%) nodules were malignant. The risk of malignancy of the TIRADS categories were as follows: TIRADS2 0%, TIRADS3 2.2%, TIRADS4A 5.9%, TIRADS4B 57.9%, TIRADS5 100% (Gamma statistic = 0.85;Spearman correlation = 0.30, Pearson’s R = 0.37, p Conclusion: Russ’ modified TIRADS classification is reliable in predicting thyroid malignancy. More evidence is nevertheless necessary for widespread adoption and use.
文摘Objective To compare the diagnostic efficiency of the thyroid imaging reporting and data system(TIRADS),the Bethesda system for reporting thyroid cytopathology(BSRTC)and BRAFV600Edetection,and their combined use in the differentiation between benign and malignant thyroid nodules.Methods One hundred
文摘目的:探讨超声造影前后能否提高甲状腺影像报告和数据系统(thyroid image report and data system,TIRADS)诊断效能。方法:选择2017年12月至2019年5月行甲状腺超声结节造影的患者151例,共152个结节,分析152个结节造影前后的二维声像特征差异,比较造影前后TI-RADS分级诊断、造影过程联合造影后TI-RADS的诊断效能。结果:造影前及造影后二维声像图上甲状腺结节边缘、钙化有统计学差异(P<0.05),回声类型无统计学差异(P>0.05)。造影前后TI-RADS分级诊断的敏感性、特异性、准确率分别为83.51%、45.45%、69.73%和96.91%、40.00%、76.32%。造影过程联合造影后TI-RADS分级的敏感性、特异性、准确率分别为83.51%、63.64%、76.32%。造影后TI-RADS、造影过程联合造影后TI-RADS的受试者工作特征曲线下面积均高于造影前(P<0.05)。结论:超声造影技术能提高二维声像图甲状腺结节边缘、钙化特征判读的准确性,造影后TI-RADS分级具有更高的敏感性,造影过程联合造影后TI-RADS具有更高的特异性,超声造影技术能够提高TI-RADS分级的诊断效能。
文摘<strong>Context: </strong>Diagnostic imaging has increased the rate of thyroid nodules detection and improved utilization of fine-needle aspiration (FNA). <strong>Objective:</strong> This study aims to demonstrate the effects of the most reliable non-invasive technique on thyroid nodules. <strong>Methods:</strong> Between 2016 and 2020, 190 patients with 214 nodules visiting King Khalid University Hospital were randomly selected and retrospectively reviewed. Following the ACR TI-RADS recommendations for FNA and correlating cytology reports. Two expert radiologists with ultrasonographic imaging experience re-evaluated and reviewed the images. 88 nodules (41%) in 79 patients were excluded because the nodule size was smaller than the FNA recommended size. <strong>Results:</strong> Following the ACR TI-RADS for FNA recommended selection, 27 nodules (21.4%) out of the recommended 126 nodules were consistent with malignancy in cytology, with overall mean sensitivities, specificities, accuracies, precisions, and negative predictive values (NPV) of 96.4%, 40.7%, 48.7%, 28.4%, and 98.6% respectively. The nodules were subdivided into the TI-RADS 3, 4, and 5.<strong> Conclusion:</strong> In conclusion, ACR TI-RADS is feasible, reliable, and well structured, easily applicable in thyroid nodules reporting. ACR TI-RADS can eliminate many unnecessary FNAs, providing a decline in costs and complications. We recommend the ACR TI-RADS in our radiology department to eliminate reporting discrepancies and cut costs, thereby standardizing the reports, improving intra-user agreements, and improving overall patients’ health care.
文摘Background: The Canadian province of Saskatchewan introduced a pre-fine needle aspiration (FNA) clinic to review adherence of referrals for thyroid biopsy based on the guidelines of the American College of Radiology’s (ACR) Thyroid Imaging, Reporting and Data System (TI-RADS) scoring system. The intention is to minimize low-yield biopsy rates by improving the quality of thyroid nodule investigation in Saskatchewan through this clinic. TI-RADS is a malignancy risk scoring system for thyroid nodules based on five sonographic characteristics: composition, echogenicity, shape, margin, and echogenic foci (calcium). Recommendations for intervention or clinical follow-up are further determined by the size of the nodule. Methods: Through a retrospective chart review of all thyroid biopsy referrals to the Royal University Hospital (RUH) in Saskatchewan between 22 March 2016 and 17 May 2018, the impact of the multidisciplinary pre-FNA clinic on appropriate thyroid biopsies in Saskatchewan was evaluated. Results: This study evaluated 252 referrals, 203 of which underwent FNA and 23 which received surgical biopsy. TI-RADS scores appended to thyroid biopsy referrals increased upon pre-FNA clinic initiation, yet score quality did not improve. Rates of malignant biopsies were lower than ACR-reporting suggesting inappropriate biopsy of low risk nodules perhaps by overcalling the TI-RADS score. The majority of FNA cytology matched final surgical pathology, with 78% of indeterminate FNAs being malignant, and all non-diagnostic FNAs being benign. Conclusions: The implementation of the pre-FNA clinic reduced the number of thyroid biopsies in Saskatchewan by 11% overall.
