TIRADS Interobserver Variability Among Indeterminate Thyroid Nodules: A Single-Institution Study.
Afirma
TIRADS
endocrine surgery
indeterminate nodules
interobserver variability
thyroid
Journal
Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine
ISSN: 1550-9613
Titre abrégé: J Ultrasound Med
Pays: England
ID NLM: 8211547
Informations de publication
Date de publication:
Jul 2019
Jul 2019
Historique:
received:
02
08
2018
revised:
10
10
2018
accepted:
20
10
2018
pubmed:
24
11
2018
medline:
8
1
2020
entrez:
24
11
2018
Statut:
ppublish
Résumé
A high proportion of cytologically indeterminate, Afirma Gene Expression Classifier "suspicious" thyroid nodules are benign. The Thyroid Imaging Reporting and Data System (TIRADS), was proposed by the American College of Radiology in 2017 to help classify thyroid nodules based on ultrasound characteristics in a standardized fashion to guide management. We aim to determine the interobserver variability of TIRADS classification among cytologically indeterminate and Afirma suspicious nodules. We retrospectively queried cytopathology archives for thyroid fine-needle aspiration specimens obtained between February 2012 and September 2016 with associated (1) indeterminate diagnosis, (2) ultrasound imaging at our institution, (3) Afirma suspicious result, and (4) surgery at our institution. We compared the TIRADS variability of the 3 blinded radiologists using intraclass correlation coefficients. Our cohort consisted of 127 nodules. Intraclass correlation coefficients can be interpreted as follows: less than 0.4, poor; 0.4 to 0.59, fair; 0.6 to 0.74, good; 0.75 to 1.00, excellent. The intraclass correlation coefficients of the raw TIRADS score and category variability was 0.561 (95% confidence interval [CI]: 0.464-0.651) or fair and 0.547 (95% CI, 0.449-0.640) or fair, respectively. When analyzing composition, echogenicity, shape, margin, and echogenic foci, the ICCs were 0.552 (95% CI, 0.454-0.643), fair; 0.533 (95% CI, 0.432-0.627), fair; 0.359 (95% CI, 0.248-0.469), poor; 0.192 (95% CI, 0.084-0.308), poor; and 0.549 (95% CI, 0.451- 0.641), fair, respectively. Our results show that among the subset of cytologically indeterminate and Afirma suspicious nodules, TIRADS interobserver variability was fair. Shape and margin criteria were the biggest sources of disagreement. Large prospective studies are needed to evaluate the interobserver variability of TIRADS in this subset of thyroid nodules.
Identifiants
pubmed: 30467876
doi: 10.1002/jum.14870
pmc: PMC7103459
mid: NIHMS1576904
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1807-1813Subventions
Organisme : NIA NIH HHS
ID : K23 AG053429
Pays : United States
Informations de copyright
© 2018 by the American Institute of Ultrasound in Medicine.
Références
Eur J Endocrinol. 2013 Apr 15;168(5):649-55
pubmed: 23416955
N Engl J Med. 2012 Aug 23;367(8):705-15
pubmed: 22731672
Acta Cytol. 2014;58(4):319-29
pubmed: 25195864
Cancer Cytopathol. 2015 Dec;123(12):713-22
pubmed: 26355876
JAMA Oncol. 2016 Aug 1;2(8):1023-9
pubmed: 27078145
Ultraschall Med. 2012 Dec;33(7):E186-E190
pubmed: 23108925
J Clin Imaging Sci. 2016 Feb 26;6:5
pubmed: 27014501
Indian J Radiol Imaging. 2016 Jan-Mar;26(1):145-52
pubmed: 27081240
Endocr Pract. 2016 May;22(5):622-39
pubmed: 27167915
Eur J Radiol. 2012 Mar;81(3):e352-6
pubmed: 22137098
Thyroid. 2016 Jan;26(1):1-133
pubmed: 26462967
Korean J Radiol. 2016 May-Jun;17(3):370-95
pubmed: 27134526
J Am Coll Radiol. 2017 May;14(5):587-595
pubmed: 28372962
Endocr Connect. 2018 Jan;7(1):1-7
pubmed: 29196301
J Clin Ultrasound. 2010 Jul;38(6):287-93
pubmed: 20544863