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Hu Huang,1 Ming-Jie Zhu,1 Qi Gao,2 Yan-Li Huang,3 Wei-Min Li4 1Department of Thyroid and Breast Surgery, Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu, People’s Republic of China; 2Department of Ultrasonography, Southeast University Affiliated Zhongda Hospital, Nanjing, Jiangsu, People’s Republic of China; 3Department of Special Clinic, General Hospital of Eastern Theater Command, PLA, Nanjing, Jiangsu, People’s Republic of China; 4Department of Ultrasonography, Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu, People’s Republic of ChinaCorrespondence: Wei-Min Li, Department of Ultrasonography, Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu, 214000, People’s Republic of China, Tel +8613912362309, Email 1005342597@qq.comPurpose: To compare the diagnostic value of the Thyroid Imaging Reporting and Data System (TI-RADS) of the American College of Radiology (ACR) versus the Chinese Thyroid Imaging Reporting and Data System (C-TIRADS) scoring and classification system for elderly thyroid cancers.Patients and Methods: A total of 512 nodules from 465 patients aged ≥ 60 with surgical pathology-proven thyroid nodules were enrolled in our study. The ultrasound features of thyroid nodules were independently evaluated by the ACR TI-RADS and C-TIRADS classification systems, and the receiver operating characteristic curve (ROC) was plotted. The optimal cut-off values of the ACR TI-RADS and C-TIRADS scoring and classification systems for diagnosing elderly thyroid nodules were estimated, and the diagnostic efficacy was analyzed.Results: The ACR TI-RADS and C-TIRADS scores and classifications of thyroid cancers were both higher than benign nodules (both P < 0.05). The area under the curve (AUC) of ACR TI-RADS and C-TIRADS scoring and classification systems were 0.861, 0.897, 0.879, and 0.900, respectively, and the AUC of the scoring system was greater than the classification system for both criteria. When the Youden index was the highe

Yue Zhou,1,&ast; Wei-Min Li,1,&ast; Xiao-Fang Fan,1 Yan-Li Huang,2 Qi Gao3 1Department of Ultrasonography, Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu, People’s Republic of China; 2Department of Special Clinic, General Hospital of Eastern Theater Command, PLA, Nanjing, Jiangsu, People’s Republic of China; 3Department of Ultrasonography, Zhongda Hospital Affiliated to Southeast University, Nanjing, Jiangsu, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Xiao-Fang Fan, Department of Ultrasonography, Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu, 214000, People’s Republic of China, Tel +8613861843829, Email fanxiaolll@126.comPurpose: To explore the diagnostic value of positive features in the Chinese Thyroid Imaging Reporting and Data System (C-TIRADS) for thyroid nodules of different sizes.Patients and Methods: A total of 1864 patients with 2347 thyroid nodules were selected from January 2021 to December 2022 and assessed according to C-TIRADS. According to the maximum diameter, nodules were divided into the A1 group (≤ 10 mm), A2 group (> 10 mm,< 20 mm), and A3 group (≥ 20 mm). With surgical pathology as the golden standard, the receiver operating characteristic curves (ROC) were constructed, and each group’s area under the curve (AUC) was calculated. The diagnostic value of positive features in C-TIRADS for different sizes of thyroid nodules was analyzed.Results: In all groups, malignant thyroid nodules had a higher incidence of positive features than benign nodules (P < 0.05). In A1 group, the diagnostic efficiency of C-TIRADS positive features for thyroid nodules was vertical orientation> ill-defined/irregular margin or extrathyroidal extension> solid composition> markedly hypoechoic> microcalcifications. The AUCs were 0.718, 0.675, 0.609, 0.558, and 0.581, respectively. In A2 group, the diagnostic efficacy of each positive features for thyroid no