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ASSESSMENT OF THE ROLE OF K-TIRADS AND ACR-TIRADS IN PREDICTING MALIGNANCY RISK OF THYROID NODULES BASED ON THE BETHESDA CLASSIFICATION
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Abstract
The study was conducted with the aim of comparing the diagnostic performance in assessing malignancy risk between the Korean Thyroid Imaging Reporting and Data System (K-TIRADS 2021) and the American College of Radiology Thyroid Imaging Reporting and Data System (ACR-TIRADS 2019), using the Bethesda classification as a reference. This descriptive study involved 220 patients with thyroid nodules who underwent ultrasound evaluation and classification by both K-TIRADS and ACR-TIRADS. Fine-needle aspiration (FNA) under ultrasound guidance was subsequently performed out at Ha Tinh city Medical Center from December 2022 to May 2024. Diagnostic performance was assessed through sensitivity (Se), specificity (Sp), positive predictive value (PPV), negative predictive value (NPV), and the area under the receiver operating characteristic curve (AUC). Results: The malignancy rate based on the Bethesda classification was 80.85%. Both the K-TIRADS and ACR-TIRADS classification systems demonstrated good effectiveness in assessing the malignancy risk of thyroid nodules. Among them, ACR-TIRADS showed superior diagnostic performance, with an AUC of 0.923, sensitivity of 99.65%, specificity of 85.07%, and diagnostic accuracy of 96.86%, all higher than those of K-TIRADS, which were 0.765, 94.70%, 58.21%, and 87.71%, respectively. Conclusion: The study shows that both the K-TIRADS and ACR-TIRADS systems are effective in assessing the malignancy risk of thyroid nodules. ACR-TIRADS demonstrated higher diagnostic value compared to K-TIRADS in evaluating thyroid nodules. Applying an appropriate ultrasound classification system can effectively support clinical decision-making and optimize diagnostic and treatment strategies for indeterminate thyroid nodules.
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Keywords
thyroid nodule, fine-needle aspiration, K-TIRADS, ACR-TIRADS, Bethesda system
References
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