ArticleEuropean radiology2025
Diagnostic performances of five US risk stratification systems for malignancy in focal [
Article in European radiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectivesThis study assessed the risk of malignancy (ROM) of nodules classified by five US risk stratification systems (US-RSSs) and evaluated the diagnostic performances of US-RSSs with biopsy criteria for diagnosing malignancy in focal [ MATERIALS AND
methodsThis retrospective cohort study included 216 patients with 236 [
resultsThe malignancy risk of intermediate-risk TIs was higher (33.8-48.2%) than the suggested ROM across all RSSs (p < 0.01). Low-risk category TIs had a significantly higher ROM (> 20%) only in Chinese-Thyroid Imaging Reporting and Data System (C-TIRADS; 35.0%, p < 0.01). The sensitivity for overall and aggressive malignancies was highest (97.3% and 100%, respectively) in the American Thyroid Association system and Korean-TIRADS, but lower (86.7-90.7% and 80.0-86.7%, respectively) in other RSSs for 189 TIs > 1 cm. American College of Radiology (ACR)-TIRADS showed the highest specificity (50.0%) and lowest unnecessary biopsy rate (30.2%, p < 0.01). Combined SUVmax-US-RSS criteria demonstrated increased sensitivity in ACR-TIRADS (96.0%, p = 0.02), but also showed greater unnecessary biopsy rates (p < 0.01).
conclusionIntermediate-risk TIs had greater ROM across RSSs, while low-risk TIs showed a significant increase only in C-TIRADS. Although US-RSSs can reduce unnecessary biopsies, European-TIRADS, ACR-TIRADS, and C-TIRADS demonstrated relatively lower sensitivity for aggressive malignancies. KEY POINTS: Question The diagnostic performance of US risk stratification systems (US-RSS) from various professional societies remains unestablished in the assessment of focal [
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