Observational studyBMC endocrine disorders2019
ACR TI-RADS and ATA US scores are helpful for the management of thyroid nodules with indeterminate cytology.
Observational study in BMC endocrine disorders, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 51 papers, 5 of them syntheses that pooled it.
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Who cites it
51 citing papers in PubMed, 5 syntheses or guidelines pooled it, 108 citations in OpenAlex.
- Comparison of diagnostic performance of two ultrasound risk stratification systems for thyroid nodules: a systematic review and meta-analysis.La Radiologia medica · 2023Pooled it
- Diagnostic performance of ultrasound risk stratification systems on thyroid nodules cytologically classified as indeterminate: a systematic review and meta-analysis.Ultrasonography (Seoul, Korea) · 2023Pooled it
- Diagnostic efficiency among Eu-/C-/ACR-TIRADS and S-Detect for thyroid nodules: a systematic review and network meta-analysis.Frontiers in endocrinology · 2023Pooled it
- Focal Thyroid Incidentalomas onFrontiers in endocrinology · 2021Pooled it
- Comparison of Diagnostic Performance of Five Different Ultrasound TI-RADS Classification Guidelines for Thyroid Nodules.Frontiers in oncology · 2020Pooled it
- Malignancy risk score in thyroid nodules with atypia of undetermined significance cytology: an approach based on cytological subgrouping and ultrasonographic data.Archives of endocrinology and metabolism · 2026Article
- Evolving trends in pediatric thyroid nodules and cancer management.Annals of pediatric endocrinology & metabolism · 2026Article
- Precision medicine in thyroid nodules: current strategies, challenges, and future directions.Hormones (Athens, Greece) · 2026Review
- The Value of Multimodal Ultrasound in Differentiating Benign from Malignant Cytologically Indeterminate Thyroid Nodules.Cancers · 2026Article
- Diagnostic accuracy of thyroid nodules with indeterminate cytology when combined with ultrasonographic risk.Saudi medical journal · 2025Article
- Great Debate: Molecular Testing and Extent of Surgery in Well-Differentiated Thyroid Cancer.Annals of surgical oncology · 2025Article
- Effects of fibroblast growth factor 21 serum level on clinicopathological findings in papillary thyroid carcinoma.Caspian journal of internal medicine · 2025Article
- Article
- Thermal ablation for Bethesda III and IV thyroid nodules: current diagnosis and management.Ultrasonography (Seoul, Korea) · 2024Article
- Superb microvascular imaging (SMI) and elastosonography in thyroid nodule: diagnostic value in a real-time cohort.Journal of ultrasound · 2024Article
- Evolutionary analysis of indeterminate cytology and risk of malignancy in a thyroid nodule unit.European thyroid journal · 2024Article
- Article
- Ultrasound Features and Performance of Afirma Gene Sequencing Classifier in Cytologically Indeterminate Thyroid Nodules.Journal of the Endocrine Society · 2024Article
- Accuracy of ultrasound in predicting thyroid malignancy: a comparative analysis of the ACR TI-RADS and ATA risk stratification systems.Archives of endocrinology and metabolism · 2024Article
- Real-Time Ultrasonography and the Evaluation of Static Images Yield Different Results in the Assessment of EU-TIRADS Categories.Journal of clinical medicine · 2023Article
Corrections and comments
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Authors and funding
9 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCytologically indeterminate thyroid nodules currently present a challenge for clinical decision-making. The main aim of our study was to determine whether the classifications, American College of Radiology (ACR) TI-RADS and 2015 American Thyroid Association (ATA) guidelines, in association with The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC), could be used to stratify the malignancy risk of indeterminate thyroid nodules and guide their clinical management.
methodsThe institutional review board approved this retrospective study of a cohort of 140 thyroid nodules in 139 patients who were referred to ultrasound-guided fine-needle aspiration cytology (FNAC) from January 2012 to June 2016 with indeterminate cytological results (44 Bethesda III, 52 Bethesda IV and 44 Bethesda V) and in whom pre-FNAC thyroid US images and histological results after surgery were available. Each included nodule was classified by one radiologist blinded to the cytological and histological diagnoses according to the ACR TIRADS scores and the US patterns as recommended in the 2015 ATA guidelines. The risk of malignancy was estimated for Bethesda, TI-RADS scores, ATA US patterns and their combination.
resultsOf the 140 indeterminate thyroid nodules examined, 74 (52.9%) were histologically benign. A different rate of malignancy (p < 0.001) among Bethesda III, IV and V was observed. The rate of malignancy increased according to the US suspicion categories (p < 0.001) in both US classifications (TI-RADS and ATA). Thyroid nodules classified as Bethesda III and the lowest risk US categories (very low, low and intermediate suspicion by ATA and 2, 3 and 4a by TI-RADS) displayed a sensitivity of 95.3% for both classifications and a negative predictive value of 94.3 and 94.1%, respectively. The highest risk US categories (high suspicion by ATA and 4b,4c and 5 by TI-RADS) were significantly associated with cancer (odds ratios [ORs] 14.7 and 9.8, respectively).
conclusionsUltrasound classifications, ACR TI-RADS and ATA guidelines, may help guide the management of indeterminate thyroid nodules, suggesting a conservative approach to nodules with low-risk US suspicion and Bethesda III, while molecular testing and surgery should be considered for nodules with high-risk US suspicion and Bethesda IV or V.
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