Thyroid nodules are very common. The main concern about a thyroid nodule is whether it is a cancer. Fortunately, ~95% of thyroid nodules are benign (noncancer). Thyroid biopsy is the best test outside of surgery in determining whether thyroid nodule is cancerous or not. Thyroid ultrasound plays a key role in characterization of thyroid nodules. Selection of thyroid nodules for biopsy is based on their ultrasound characterization. Several ultrasound-based risk stratification systems have been developed to determine which nodules should be referred for biopsy. Most commonly used are classifications from the American Thyroid Association, the American Association of Clinical Endocrinologists, the American College of Radiology Thyroid Imaging Reporting and Data System (ACR-TIRADS), the European Thyroid Association, and the Korean Society of Thyroid Radiology Thyroid Imaging Reporting and Data System (K-TIRADS). The TIRADS system provides points on size, margins, structure/composition, echotexture, calcifications and extension outside of the thyroid and based on that system, biopsy is recommended on a point basis. The goal of this study was to compare the ability of the 5 most widely used ultrasound-based riskstratification systems to identify nodules that do not need further evaluation with thyroid biopsy without missing cancerous nodules.
THE FULL ARTICLE TITLE:
Grani G et al 2019 Reducing the number of unnecessary thyroid biopsies while improving diagnostic accuracy: toward the “right” TIRADS. J Clin Endocrinol Metab 104:95–102. PMID: 30299457.
SUMMARY OF THE STUDY
This is a study of 520 nodules in 477 patients that were refereed for thyroid biopsy to a single center in Italy.