目的:比较美国放射学会(ACRTI-RADS)提出的甲状腺影像报告和数据系统(TI-RADS)之间的差异,Kwak提出的TI-RADS(KwakTI-RADS),和美国甲状腺协会(ATA)的特异性指南,灵敏度和不必要的FNA速率(UFR,假阳性率)推荐的细针穿刺(FNA),并以推荐的FNA结节大小阈值观察KwakTI-RADS和ATA指南中UFR的变化。
方法:具体情况,ACRTI-RADS中推荐的FNA的敏感性和UFR,计算并比较了ATA指南和KwakTI-RADS。对ATA指南和KwakTI-RADS推荐的FNA的结节大小进行了系统的改变,以建立新的FNA阈值。具体情况,计算了新模型下推荐的FNA的敏感性和UFR,并与ACRTI-RADS中的敏感性和UFR进行了比较.
结果:对于所有甲状腺结节,ACRTI-RADS中的UFR,ATA指南和KwakTI-RADS为26.3%,47.4%和40.0%,分别。ACRTI-RADS中的UFR低于其他推荐的FNA在ACRTI-RADS中的特异性(73.7%)高于其他(均P<0.001),但推荐的FNA在ACRTI-RADS中的敏感性(89.3%)低于其他(均P<0.001)。当结节大小阈值为ATA指南推荐的FNA时,中间可疑,低怀疑,和非常低的怀疑,和KwakTI-RADS等级4b和4a逐渐增加,UFR逐渐下降。
结论:KwakTI-RADS和ATA指南推荐的FNAUFR高于ACRTI-RADS,并且受到推荐的FNA结节大小阈值的影响。
OBJECTIVE: To compare the differences among the thyroid imaging reporting and data system (TI-RADS) proposed by American College of Radiology (ACR TI-RADS), TI-RADS proposed by Kwak (Kwak TI-RADS), and American Thyroid Association (ATA)
guidelines in the specificity, sensitivity and the unnecessary FNA rate (the UFR, the false positive rate) of recommended fine needle aspiration (FNA), and to observe the changes of the UFR in the KwakTI-RADS and ATA guidelines with the recommended FNA nodule size threshold.
METHODS: The specificities, sensitivities and UFRs of recommended FNA in the ACR TI-RADS, ATA
guidelines and Kwak TI-RADS were calculated and compared. The nodule sizes for recommended FNA of ATA
guidelines and Kwak TI-RADS were systematically varied to establish new FNA thresholds. The specificities, sensitivities and UFRs of recommended FNA under the new models were calculated and compared to those in the ACR TI-RADS.
RESULTS: For all thyroid nodules, the UFRs in the ACR TI-RADS, ATA
guidelines and Kwak TI-RADS were 26.3%, 47.4% and 40.0%, respectively. The UFR in the ACR TI-RADS was lower than that in the others, and the specificity of recommended FNA in the ACR TI-RADS(73.7%) was higher than that in the others (all P < 0.001), but the sensitivity of recommended FNA in the ACR TI-RADS(89.3%) was lower than that in the others (all P < 0.001). When nodule sizes threshold of the recommended FNA for ATA guidelines Intermediate Suspicion, Low Suspicion, and Very Low Suspicion, and Kwak TI-RADS grade 4b and 4a were gradually increased, the UFRs gradually decreased.
CONCLUSIONS: The UFRs of FNA recommended by the Kwak TI-RADS and ATA
guidelines were higher than that of the ACR TI-RADS, and were affected by the recommended FNA nodule size threshold.