Considerable interobserver variation calls for unambiguous definitions of thyroid nodule ultrasound characteristics
Authors' conclusion
Examination of video recordings, closely simulating the real-world situation, revealed substantial interobserver variation in the interpretation of each of the four most important ultrasound characteristics. In view of the importance for the management of thyroid nodules, unambiguous and widely accepted definitions of each nodule characteristic are warranted, although it remains to be investigated whether this diminishes observer variation.
Study context
- Population
- Ultrasound video recordings of 47 consecutive malignant and 76 consecutive benign thyroid lesions, evaluated by 7 experts from 7 thyroid centers7 experts
- Outcome
- Interobserver variation of each Thyroid Imaging Reporting and Data System (TIRADS)-related US characteristic (Gwet's AC1; higher = better concordance, max 1.0)
Methodological detailsblinded online evaluation of video recordings, 7 thyroid centers, surgical histology as reference standard
- Blinded online evaluation of video recordings
- 7 thyroid centers
- Surgical histology as reference standard
Main finding
As reported in the abstract
Irregular margins
0.34
Microcalcifications
0.53
Echogenicity
0.72
Extrathyroidal extension
0.79
Further findings
Concordance in discriminating mildly/moderately vs very hypoechogenic nodules
- Gwet's AC1
- 0.17
Agreement by nodule size
- Smaller nodules: better agreement in echogenicity; larger nodules: better agreement on presence of microcalcifications
Extrathyroidal extension correctly identified
- Cases correctly identified
- 45.8%
Original publication
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