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Abstract：
UNASSIGNED: To compare the diagnostic performance in determining the malignancy of thyroid nodules and the fine needle aspiration (FNA) recommendations of the guidelines set forth by the Superficial Organ and Vascular Ultrasound Group of the Society of Ultrasound in Medicine of the Chinese Medical Association in 2020 [2020 Chinese Thyroid Imaging Reporting and Data System (C-TIRADS)], the American College of Radiology in 2017 (2017 ACR-TIRADS) and the American Thyroid Association in 2015 (2015 ATA guidelines).
UNASSIGNED: From January 2021 to December 2021, 1,228 thyroid nodules with definitive postoperative histopathology and ultrasound (US) examination within 3 months before surgery in Shantou Central Hospital were enrolled in this study. We collected the data in 2022. The participants formed a consecutive series. The clinical and US features of the nodules were retrospectively reviewed and categorized according to the 2020 C-TIRADS, the 2017 ACR-TIRADS and the 2015 ATA guidelines. The diagnostic performance and unnecessary FNA rates of the three guidelines were calculated.
UNASSIGNED: The 2017 ACR-TIRADS had the highest diagnostic performance [area under the receiver operating characteristic curve (AUROC) 0.938], followed by the 2020 C-TIRADS (AUROC 0.933) and the 2015 ATA guidelines (AUROC 0.928). The ATA guidelines had the highest specificity (93.38%), accuracy (92.10%) and positive predictive value (PPV) (80.56%) among the three guidelines. There were no significant differences in the sensitivity and negative predictive value (NPV) among the three guidelines. The sensitivity, specificity, PPV, NPV and accuracy of the FNA recommendations based on the C-TIRADS were 84.25%, 58.76%, 38.92%, 92.28% and 64.82%, respectively, which were higher than those of the ACR-TIRADS (57.53%, 42.94%, 23.93%, 76.43% and 46.42%, respectively) and the ATA guidelines (62.67%, 13.25%, 18.39%, 53.22% and 25.00%, respectively). Compared with the ACR-TIRADS (76.07%) and the ATA guidelines (81.61%), the C-TIRADS showed advantages in the unnecessary FNA rate (61.08%), especially in nodules larger than 20 mm.
UNASSIGNED: The 2020 C-TIRADS, the 2017 ACR-TIRADS and the 2015 ATA guidelines can effectively predict the malignancy risk of thyroid nodules. Compared with the 2017 ACR-TIRADS and the 2015 ATA guidelines, the 2020 C-TIRADS may offer a meaningful reduction in FNA recommendations with the highest efficacy in distinguishing thyroid carcinoma.
UNASSIGNED: From January 2021 to December 2021, 1,228 thyroid nodules with definitive postoperative histopathology and ultrasound (US) examination within 3 months before surgery in Shantou Central Hospital were enrolled in this study. We collected the data in 2022. The participants formed a consecutive series. The clinical and US features of the nodules were retrospectively reviewed and categorized according to the 2020 C-TIRADS, the 2017 ACR-TIRADS and the 2015 ATA guidelines. The diagnostic performance and unnecessary FNA rates of the three guidelines were calculated.
UNASSIGNED: The 2017 ACR-TIRADS had the highest diagnostic performance [area under the receiver operating characteristic curve (AUROC) 0.938], followed by the 2020 C-TIRADS (AUROC 0.933) and the 2015 ATA guidelines (AUROC 0.928). The ATA guidelines had the highest specificity (93.38%), accuracy (92.10%) and positive predictive value (PPV) (80.56%) among the three guidelines. There were no significant differences in the sensitivity and negative predictive value (NPV) among the three guidelines. The sensitivity, specificity, PPV, NPV and accuracy of the FNA recommendations based on the C-TIRADS were 84.25%, 58.76%, 38.92%, 92.28% and 64.82%, respectively, which were higher than those of the ACR-TIRADS (57.53%, 42.94%, 23.93%, 76.43% and 46.42%, respectively) and the ATA guidelines (62.67%, 13.25%, 18.39%, 53.22% and 25.00%, respectively). Compared with the ACR-TIRADS (76.07%) and the ATA guidelines (81.61%), the C-TIRADS showed advantages in the unnecessary FNA rate (61.08%), especially in nodules larger than 20 mm.
UNASSIGNED: The 2020 C-TIRADS, the 2017 ACR-TIRADS and the 2015 ATA guidelines can effectively predict the malignancy risk of thyroid nodules. Compared with the 2017 ACR-TIRADS and the 2015 ATA guidelines, the 2020 C-TIRADS may offer a meaningful reduction in FNA recommendations with the highest efficacy in distinguishing thyroid carcinoma.
摘要：
■比较2020年中华医学会超声医学学会浅部器官和血管超声组（2020年中国甲状腺影像学报告和数据系统（C-TIRADS））指南中确定甲状腺结节恶性的诊断性能和细针穿刺（FNA）建议，2017年美国放射学会（2017ACR-TIRADS）和2015年美国甲状腺协会（2015ATA指南）。
■本研究纳入2021年1月至2021年12月汕头市中心医院1,228个甲状腺结节，术前3个月内有明确的术后组织病理学及超声（US）检查。我们在2022年收集了数据。参与者组成了连续的系列。根据2020年C-TIRADS对结节的临床和US特征进行回顾性分析和分类，2017年ACR-TIRDS和2015年ATA指南。计算了三个指南的诊断性能和不必要的FNA率。
■2017ACR-TIRADS具有最高的诊断性能[接收器工作特性曲线下的面积（AUROC）0.938]，其次是2020年C-TIRADS（AUROC0.933）和2015年ATA指南（AUROC0.928）。ATA指南的特异性最高（93.38%），三个指南的准确性（92.10%）和阳性预测值（PPV）（80.56%）。三个指南之间的敏感性和阴性预测值（NPV）没有显着差异。敏感性,特异性，PPV,基于C-TIRADS的FNA建议的NPV和准确性为84.25%，58.76%,38.92%,92.28%和64.82%，分别,高于ACR-TIRADS(57.53%，42.94%,23.93%,76.43%和46.42%，分别)和ATA指南(62.67%，13.25%,18.39%,53.22%和25.00%，分别)。与ACR-TIRADS（76.07%）和ATA指南（81.61%）相比，C-TIRADS在不必要的FNA率（61.08%）方面表现出优势，特别是在大于20毫米的结节中。
■2020年C-TIRADS，2017年ACR-TIRADS和2015年ATA指南可有效预测甲状腺结节的恶性风险.与2017年ACR-TIRADS和2015年ATA指南相比，2020年C-TIRADS可以显著减少FNA推荐,在区分甲状腺癌方面效果最高.
■本研究纳入2021年1月至2021年12月汕头市中心医院1,228个甲状腺结节，术前3个月内有明确的术后组织病理学及超声（US）检查。我们在2022年收集了数据。参与者组成了连续的系列。根据2020年C-TIRADS对结节的临床和US特征进行回顾性分析和分类，2017年ACR-TIRDS和2015年ATA指南。计算了三个指南的诊断性能和不必要的FNA率。
■2017ACR-TIRADS具有最高的诊断性能[接收器工作特性曲线下的面积（AUROC）0.938]，其次是2020年C-TIRADS（AUROC0.933）和2015年ATA指南（AUROC0.928）。ATA指南的特异性最高（93.38%），三个指南的准确性（92.10%）和阳性预测值（PPV）（80.56%）。三个指南之间的敏感性和阴性预测值（NPV）没有显着差异。敏感性,特异性，PPV,基于C-TIRADS的FNA建议的NPV和准确性为84.25%，58.76%,38.92%,92.28%和64.82%，分别,高于ACR-TIRADS(57.53%，42.94%,23.93%,76.43%和46.42%，分别)和ATA指南(62.67%，13.25%,18.39%,53.22%和25.00%，分别)。与ACR-TIRADS（76.07%）和ATA指南（81.61%）相比，C-TIRADS在不必要的FNA率（61.08%）方面表现出优势，特别是在大于20毫米的结节中。
■2020年C-TIRADS，2017年ACR-TIRADS和2015年ATA指南可有效预测甲状腺结节的恶性风险.与2017年ACR-TIRADS和2015年ATA指南相比，2020年C-TIRADS可以显著减少FNA推荐,在区分甲状腺癌方面效果最高.
