Comparison of the diagnostic accuracy of K-TIRADS and EU-TIRADS guidelines for detection of thyroid malignancy on ultrasound

Abstract

IntroductionThis retrospective study compared the diagnostic accuracy of histopathologically proven thyroid nodules between the Korean Thyroid Imaging Reporting and Data System (K-TIRADS) and the European Thyroid Imaging Reporting and Data System (EU-TIRADS) guidelines for the management of thyroid nodules characterized by ultrasonography. Material and methodsFor thyroid nodules resected from 2018 to 2021 at our institution, static ultrasound images of each nodule were reviews and stratify into both systems. Agreement between above two classifications was compared based on histopathological results. ResultsA total 403 thyroid nodules from 213 patients were evaluated. Each nodule was characterized by ultrasonography and stratified into K-TIRADS and EU-TIRADS classifications. The diagnostic accuracy was as follows: K-TIRADS sensitivity 85.3% (95% CI, 78.7–91.9) specificity 76.8% (95% CI, 72.1–81.7), positive predictive value 57.8% (95% CI, 50.1–65.4) negative predictive value 93.4% (95% CI, 90.3–96.5); EU-TIRADS sensitivity 86.2% (95% CI, 79.7–92.7), specificity 75.5% (95% CI, 70.6–80.4), positive predictive value 56.6% (95% CI, 49.1–64.2), negative predictive value 93.7% (95% CI, 90.6–96.8). Excellent agreement in risk stratifications between both systems was found (kappa 0.86). ConclusionsUltrasound thyroid nodules categorized by either by K-TIRADS or EU-TIRADS are useful to predicting malignancy and perform risk stratification with similar results. Implications for practiceThis study confirmed that both K-TIRADS and EU-TIRADS have high diagnostic accuracy and both guidelines may be used as an effective tool for management planning of patients with thyroid nodules in daily clinical practice.