Thyroid nodules: diagnostic performance of ATA and ACR tirads on risk for malignancy

Abstract

Aim: we aimed to compare the American Thyroid Association (ATA) and The American College of Radiology Thyroid Imaging Reporting and Data System (ACR TIRADS) guidelines that stratify the risk of nodule malignancy and compare with cytological classification. Then, the diagnostic performance of the ATA and ACR TIRADS categories for predicting malignancy were performed. Methods: a total of 190 thyroid nodules image obtained from 120 individuals were classified in accordance with ACR TIRADS and ATA guidelines. After classified, all nodules were categorized by using cytological classification (2017 Bethesda System). Results: comparing diagnostic accuracy of each ultrasound classification, both of them revealed the same sensitivity and negative predictive value but ACR TIRADS reached higher positive predictive value. A high positive correlation between the two methods were found (r=0.860, p <0.0001). The ATA and ACR TIRADS classifications were correlated with the cytological analysis, but the correlation was weak. Conclusions: Both guidelines have similar accuracy in the ultrasound evaluation of thyroid nodules but have shown an overestimation of the presence of malignant thyroid neoplasms.