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Malignancy risk stratification and subcategorization of K-TIRADS intermediate suspicion thyroid nodules: a retrospective multicenter study

Title
Malignancy risk stratification and subcategorization of K-TIRADS intermediate suspicion thyroid nodules: a retrospective multicenter study
Authors
LeeBoeunNaDong GyuKimJi-Hoon
Ewha Authors
이보은
Issue Date
2024
Journal Title
Ultrasonography
ISSN
2288-5919JCR Link
Citation
Ultrasonography vol. 43, no. 2, pp. 132 - 140
Keywords
Fine-needle aspirationThyroid Imaging Reporting and Data SystemThyroid neoplasmsThyroid noduleUltrasonography
Publisher
Korean Society of Ultrasound in Medicine
Indexed
SCOPUS; KCI; SCIE scopus
Document Type
Article
Abstract
Purpose: This study aimed to develop the ultrasonography (US) criteria for risk stratification of the Korean Thyroid Imaging Reporting and Data System (K-TIRADS) 4 nodules, and to evaluate the diagnostic yield of a modified biopsy criterion in a multicenter cohort. Methods: In total, 1,542 K-TIRADS 4 nodules (≥1 cm) were included in the study. US criteria for the subcategorization of K-TIRADS 4 nodules were developed based on high-risk US features. The diagnostic yields and false referral rates of biopsy criterion 1 (size cut-off of 1 cm), biopsy criterion 2 (size cut-off of 1.5 cm), and modified biopsy criterion 3 (size cut-off of 1 cm for K-TIRADS 4B and 1.5 cm for K-TIRADS 4A) were evaluated. Results: The five high-risk US features (solid composition, marked hypoechogenicity, macrocalcification, punctate echogenic foci, and irregular margin) independently increased the malignancy risk of the K-TIRADS 4 nodules (P<0.001). The K-TIRADS 4 nodules could be subcategorized into higher-and lower-risk subcategories according to the number of high-risk US features: K-TIRADS 4B (≥2 US features) and K-TIRADS 4A (≤1 US feature). The modified biopsy criterion increased the diagnostic yield by 7.8% compared with criterion 2 and reduced the false referral rate by 15.3% compared with criterion 1 (P<0.001). Conclusion: The K-TIRADS 4 nodules were subcategorized as K-TIRADS 4B and K-TIRADS 4A based on high-risk US features. The modified biopsy criterion 3 showed a similar diagnostic yield and reduced false referral rate compared to criterion 1. © 2024 Korean Society of Ultrasound in Medicine (KSUM).
DOI
10.14366/usg.23203
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ETC > ETC
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