A prospective comparison of ACR‐TIRADS and European (EU)‐TIRADS in thyroid nodule assessment for fine-needle aspiration (FNA)‐ultrasound (US)
Authors' conclusion
Both systems presented high sensitivity, but low specificity in selecting nodules for FNA-US. The use of nodular size for FNA-US selection is questioned.
Study context
- Population
- Consecutive patients with one or more thyroid nodule(s) undergoing US-guided FNA (FNA-US); reference standard FNA-US cytology and histopathology186 nodules
- Participants
- 166 patients
- Comparison
- American College of Radiology Thyroid Imaging Reporting and Data System (ACR-TIRADS) vs EU-TIRADS
- Outcome
- Diagnostic accuracy of ACR-TIRADS and EU-TIRADS
Methodological detailsconsecutive patients
- Consecutive patients
Performance
As reported in the abstract
Diagnostic accuracy (168 nodules, 149 patients with conclusive results)
| Test or model | Sensitivity | Specificity | NPV | False negative |
|---|---|---|---|---|
| ACR-TIRADS | 100.0% | 28.7% | 100.0% | 0.0% |
| EU-TIRADS | 90.0% | 19.1% | 96.8% | 9.1% (n = 1) |
Sensitivity
ACR-TIRADS100.0%
EU-TIRADS90.0%
Specificity
ACR-TIRADS28.7%
EU-TIRADS19.1%
NPV
ACR-TIRADS100.0%
EU-TIRADS96.8%
False negative
ACR-TIRADS0.0%
EU-TIRADS9.1% (n = 1)
Further findings
Unnecessary FNA-US · lower with ACR-TIRADS
P = 0.017
Possibly avoided FNA-US
Possibly avoided FNA-US with FNA only in highly suspicious nodules and/or lymphadenopathy
EU-TIRADS with ACR-TIRADS size threshold (2.5 cm) for EU-TIRADS 3 nodules
- Specificity
- 30.6%
- Avoided FNA-US
- 28.6%
Possibly avoided FNA-US with FNA only in highly suspicious nodules and/or lymphadenopathy
- Without increasing false negatives
Original publication
A prospective comparison of ACR‐TIRADS and EU‐TIRADS in thyroid nodule assessment for FNA‐US. Clin Endocrinol (Oxf). Published 3 August 2022. doi:10.
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