Original articles

Interobserver variability in sonographic evaluation of thyroid nodules with ACR-TIRADS and RJ-TIRADS

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  • Department of Ultrasonic Diagnosis, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China

Received date: 2018-06-29

  Online published: 2019-04-25

Abstract

Objective: To evaluate the interobserver variability with the ACR TIRADS(American Radiological Society-Thyroid Imaging Reporting and Data System)and RJ-TIRADS (Ruijin-Thyroid Imaging Reporting and Data System)descriptive category terms of sonographic (US) features ofthyroid nodules. Methods: Retrospective analysis was conducted on 597 nodules. The US findings of each thyroid nodule were analyzed by two radiologists having at least 5 years of experience. All these cases had been pathologically confirmed. Interobserver variability was calculated using Cohen's Kappa statistics. Results: All the descriptive terms had statistical significance. In ACR-TIRADS, there were fair agreement for margin, moderate agreement forecho and calcification; internal structure showed substantial agreement.In RJ-TIRADS, there were no descriptive terms with weak agreement. Moderate agreement was found for echo level and internal blood flow, while substantial agreement was found with regard to margin, boundary, internal structure and calcification. With regard to category, for ACR-TIRADS, TIRADS 1, 2, 3 and 5 showed substantial agreement, while TIRADS 4 showed moderate agreement; for RJ-TIRADS, TI-RADS3, 4C and 5 showed substantial agreement, while TIRADS 4A and 4B showed moderate agreement. If the TIRADS 4 category was evaluated as a whole, the agreement between observerswas better. Conclusions: Both versions of TIRADS have good clinical value in evaluating thyroid nodules. In ACR-TIRADS, the agreement for margin is somewhat weaker, and should be evaluated as a whole or evaluated carefully when used. Both versions of TIRADS require further study to improve the agreement between observers, and classes 4A and 4B in RJ-TIRADS could be combined for elevating the agreement.

Cite this article

XU Shangyan, JIA Xiaohong, NI Xiaofeng, ZHAN Weiwei . Interobserver variability in sonographic evaluation of thyroid nodules with ACR-TIRADS and RJ-TIRADS[J]. Journal of Diagnostics Concepts & Practice, 2019 , 18(2) : 149 -154 . DOI: 10.16150/j.1671-2870.2019.02.006

References

[1] Grant EG, Tessler FN, Hoang JK, et al. Thyroid Ultrasound Reporting Lexicon: White Paper of the ACR Thyroid Imaging, Reporting and Data System (TIRADS) Committee[J]. J Am Coll Radiol, 2015, 12(12 Pt A):1272-1279.
[2] Reiners C, Wegscheider K, Schicha H, et al. Prevalence of thyroid disorders in the working population of Germany: ultrasonography screening in 96,278 unselected employees[J]. Thyroid, 2004, 14(11):926-932.
[3] Guth S, Theune U, Aberle J, et al. Very high prevalence of thyroid nodules detected by high frequency(13 MHz) ultrasound examination[J]. Eur J Clin Invest, 2009, 39(8):699-706.
[4] Horvath E, Majlis S, Rossi R, et al. An ultrasonogram reporting system for thyroid nodules stratifying cancer risk for clinical management[J]. J Clin Endocrinol Metab, 2009, 94(5):1748-1751.
[5] Park JY, Lee HJ, Jang HW, et al. A proposal for a thyroid imaging reporting and data system for ultrasound features of thyroid carcinoma[J]. Thyroid, 2009, 19(11):1257-1264.
[6] Kwak JY, Han KH, Yoon JH, et al. Thyroid imaging reporting and data system for US features of nodules: a step in establishing better stratification of cancer risk[J]. Radiology, 2011, 260(3):892-899.
[7] Xu SY, Zhan WW, Wang WH. Evaluation of Thyroid Nodules by a Scoring and Categorizing Method Based on Sonographic Features[J]. J Ultrasound Med, 2015, 34(12):2179-2185.
[8] Tessler FN, Middleton WD, Grant EG, et al. ACR Thyroid Imaging, Reporting and Data System (TI-RADS): White Paper of the ACR TI-RADS Committee[J]. J Am Coll Radiol, 2017, 14(5):587-595.
[9] 刘玉琴, 张书全, 陈万青, 等. 中国2003-2007年甲状腺癌发病死亡现状及流行趋势分析[J]. 中华流行病学杂志, 2012, 33(10):1044-1048.
[10] Ahn HS, Kim HJ, Welch HG. Korea's thyroid-cancer "epidemic"--screening and overdiagnosis[J]. N Engl J Med, 2014, 371(19):1765-1767.
[11] Oda H, Miyauchi A, Ito Y, et al. Incidences of Unfavo-rable Events in the Management of Low-Risk Papillary Microcarcinoma of the Thyroid by Active Surveillance Versus Immediate Surgery[J]. Thyroid, 2016, 26(1):150-155.
[12] Russ G, Bigorgne C, Royer B, et al. The Thyroid Imaging Reporting and Data System (TIRADS) for ultrasound of the thyroid[J]. J Radiol, 2011, 92(7-8):701-713.
[13] Shin JH, Baek JH, Chung J, et al. Ultrasonography Diagnosis and Imaging-Based Management of Thyroid No-dules: Revised Korean Society of Thyroid Radiology Consensus Statement and Recommendations[J]. Korean J Radiol, 2016, 17(3):370-395.
[14] Moon WJ, Jung SL, Lee JH, et al. Benign and malignant thyroid nodules: US differentiation--multicenter retrospective study[J]. Radiology, 2008, 247(3):762-770.
[15] Choi SH, Kim EK, Kwak JY, et al. Interobserver and intraobserver variations in ultrasound assessment of thyroid nodules[J]. Thyroid, 2010, 20(2):167-172.
[16] Park CS, Kim SH, Jung SL, et al. Observer variability in the sonographic evaluation of thyroid nodules[J]. J Clin Ultrasound, 2010, 38(6):287-293.
[17] Wienke JR, Chong WK, Fielding JR, et al. Sonographic features of benign thyroid nodules: interobserver reliabi-lity and overlap with malignancy[J]. J Ultrasound Med, 2003, 22(10):1027-1031.
[18] 徐上妍, 詹维伟, 周建桥, 等. 超声评估甲状腺结节内钙化的初步探讨[J]. 中国超声医学杂志, 2012, 28(9):789-792.
[19] 徐上妍, 詹维伟. 超声诊断指标量化评估甲状腺结节[J]. 中国医学影像技术, 2012, 28(4):656-659.
[20] Malhi H, Beland MD, Cen SY, et al. Echogenic foci in thyroid nodules: significance of posterior acoustic artifacts[J]. AJR Am J Roentgenol, 2014, 203(6):1310-1316.
[21] Remonti LR, Kramer CK, Leitão CB, et al. Thyroid ultrasound features and risk of carcinoma: a systematic review and meta-analysis of observational studies[J]. Thyroid, 2015, 25(5):538-550.
[22] 燕山, 詹维伟, 周建桥. 甲状腺与甲状旁腺超声影像学[M]. 科学技术文献出版社, 2009.
[23] 计静丹, 詹维伟, 徐上妍. 彩色多普勒超声鉴别甲状腺结节良恶性价值的再探讨[J]. 中华医学超声杂志(电子版), 2011, 8(6):1289-1291.
[24] Moon HJ, Kwak JY, Kim MJ, et al. Can vascularity at power Doppler US help predict thyroid malignancy?[J]. Radiology, 2010, 255(1):260-269.
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