Back to Search
Start Over
Malignancy risk stratification and FNA recommendations for thyroid nodules: A comparison of ACR TI-RADS, AACE/ACE/AME and ATA guidelines.
- Source :
-
American journal of otolaryngology [Am J Otolaryngol] 2020 Nov - Dec; Vol. 41 (6), pp. 102625. Date of Electronic Publication: 2020 Jun 24. - Publication Year :
- 2020
-
Abstract
- Objective: To compare diagnostic performance and malignancy risk stratification among guidelines set forth by the American Thyroid Association (ATA) in 2015, the American Association of Clinical Endocrinologists (AACE), the American College of Endocrinology (ACE) and the Association Medici Endocrinologi (AME) in 2016, and the American College of Radiology (ACR) in 2017.<br />Methods: The retrospective study was approved by the hospital ethics committee, and the informed consent requirement was waived. From October 2015 to March 2016, a total of 230 patients with 230 consecutive thyroid nodules were enrolled in this study. Each nodule was classified by one junior and one senior radiologist separately according to ACR TI-RADS, AACE/ACE/AME and ATA guidelines. The malignancy diagnostic performance and the number of FNA recommendations were pairwise compared among three guidelines using chi-square tests.<br />Results: Of the 230 thyroid nodules, 137 were malignant, and 93 were benign. However, 19.6% of the nodules (45 of 230) did not match any pattern using the ATA guidelines but with a high risk of malignancy (68.9%). The ACR TI-RADS derived the highest diagnostic performance, from both junior radiologist (AUC 0.815) and senior radiologist (AUC 0.864). The ACR guidelines also showed the greatest level of sensitivity (junior: 86.1%, senior: 94.9%), compared with AACE/ACE/AME and ATA guidelines. The number of thyroid nodules recommended to fine-needle aspiration (FNA) was the lowest (37.8%, 40.4%) by ACR TI-RADS, and meanwhile, the malignant detection rate within these nodules was highest (64.4%, 68.8%).<br />Conclusions: The ACR guidelines present a higher level of diagnostic indicators and may offer a meaningful reduction in FNA recommendations with a higher malignancy detection rate.<br /> (Copyright © 2020 Elsevier Inc. All rights reserved.)
- Subjects :
- Adolescent
Adult
Aged
Female
Humans
Male
Middle Aged
Retrospective Studies
Risk
Young Adult
Biopsy, Fine-Needle statistics & numerical data
Endocrinology organization & administration
Practice Guidelines as Topic
Radiology organization & administration
Societies, Medical organization & administration
Thyroid Neoplasms diagnosis
Thyroid Neoplasms pathology
Thyroid Nodule diagnosis
Thyroid Nodule pathology
Subjects
Details
- Language :
- English
- ISSN :
- 1532-818X
- Volume :
- 41
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- American journal of otolaryngology
- Publication Type :
- Academic Journal
- Accession number :
- 32668355
- Full Text :
- https://doi.org/10.1016/j.amjoto.2020.102625