Abstract：
Thyroid Imaging Reporting and Data Systems (TIRADSs) have been largely diffused for their high accuracy in risk stratification of thyroid nodules (TNs) and their selection for fine-needle aspiration cytology (FNAC). The most popular TIRADSs are ACR-, EU-, and K-TIRADS, with some discrepancies each other. One major difference is that ACR-TIRADS includes a recommendation in favor of follow-up in TNs having a major diameter insufficient to indicate FNAC. The present study aimed to explore prevalence and significance of this recommendation. EU- and K-TIRADS were used as comparator. A retrospective series of thyroidectomies was searched according to a pre-defined protocol. The study period was 2019-2023. Preoperative ultrasound images were reviewed by radiologists blinded of clinical data. Matching of TIRADS and histology was performed later. Histology was the gold standard. The study series included 39 TNs classified as category 3, 4, or 5 and assessed for follow-up according to ACR-TIRADS. The overall cancer frequency was 25.6%, being 13% in category 3, 20% in category 4, and 83.3% in category 5. The category assessment according to ACR-, EU-, and K-TIRADS was not significantly different. EU-TIRADS indicated FNAC in 10 TNs of which two cancers and eight benign lesions. K-TIRADS recommended FNAC in 32 TNs of which seven cancers and 25 benign lesions. TNs assessed for follow-up according to ACR-TIRADS are cancer in one-fourth of cases. EU- and, especially, K-TIRADS allow us to select for FNAC cancers, with the burden of non-negligible frequency of unnecessary FNACs.
摘要：
甲状腺成像报告和数据系统（TIRADS）因其在甲状腺结节（TNs）的风险分层中的高准确性及其在细针穿刺细胞学（FNAC）中的选择而得到了广泛的传播。最受欢迎的TIRADS是ACR-，欧盟-,和K-TIRADS,彼此有些差异。一个主要区别是ACR-TIRADS包括有利于对具有不足以指示FNAC的大直径的TNs进行随访的建议。本研究旨在探讨这一建议的普遍性和意义。Eu-和K-TIRADS用作比较物。根据预定义的方案搜索了一系列回顾性的甲状腺切除术。研究期为2019-2023年。术前超声图像由对临床数据不知情的放射科医生进行审查。稍后进行TIRADS和组织学的匹配。组织学是黄金标准。该研究系列包括39个分为3、4或5类的TNs，并根据ACR-TIRADS进行随访评估。总体癌症发生率为25.6%，在类别3中占13％，在类别4中占20％，在类别5中占83.3％。根据CR-的类别评估，欧盟-,和K-TIRADS没有显著差异。EU-TIRADS在10个TNs中显示FNAC，其中2个癌症和8个良性病变。K-TIRADS在32个TNs中推荐FNAC，其中7个癌症和25个良性病变。根据ACR-TIRADS评估的随访TNs在四分之一的病例中是癌症。欧盟-和，尤其是,K-TIRADS允许我们选择FNAC癌症，具有不可忽视的不必要的FNAC频率的负担。
