Retrospective study from a single center to comparison of diagnostic value of three thyroid imaging reporting and data systems in Bethesda III/IV thyroid nodules

ObjectivesTo compare the diagnostic value of ACR Thyroid Imaging Reporting and Data System (TI-RADS), K-TIRADS, and C-TIRADS in Bethesda III/IV thyroid nodules.MethodsThis single-center retrospective study classified 80 Bethesda stage III/IV thyroid nodules from 80 patients between January 2020 and...

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Main Authors: Jie Guo, Liang Du, Wenjuan Bi, Yuchen Liu, Cuiming Zhang
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-04-01
Series:Frontiers in Oncology
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Online Access:https://www.frontiersin.org/articles/10.3389/fonc.2025.1549646/full
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author Jie Guo
Liang Du
Wenjuan Bi
Yuchen Liu
Cuiming Zhang
Cuiming Zhang
author_facet Jie Guo
Liang Du
Wenjuan Bi
Yuchen Liu
Cuiming Zhang
Cuiming Zhang
author_sort Jie Guo
collection DOAJ
description ObjectivesTo compare the diagnostic value of ACR Thyroid Imaging Reporting and Data System (TI-RADS), K-TIRADS, and C-TIRADS in Bethesda III/IV thyroid nodules.MethodsThis single-center retrospective study classified 80 Bethesda stage III/IV thyroid nodules from 80 patients between January 2020 and July 2023 according to three different systems. Diagnostic performance was evaluated using receiver operating characteristic curves, with histopathological diagnosis serving as the reference standard.ResultsOverall, 41/80 (51.2%) nodules were malignant and 39/80 (48.8%) were benign. The malignancy rates for Bethesda type III and IV nodules were 50.7% and 55.6%, respectively. The malignancy risk in thyroid nodules increased with higher TI-RADS categories (P<0.001). Optimal cutoff values for ACR-, K-, and C-TIRADS were categories 5, 5, and 4C, respectively. Area under the curve (AUC) for ACR-, K-, and C-TIRADS was 0.782, 0.767, and 0.842, respectively, with C-TIRADS showing a significantly higher AUC than ACR-TIRADS and K-TIRADS (all P<0.05). C-TIRADS demonstrated the highest sensitivity, accuracy, and positive predictive value, whereas ACR TI-RADS showed the highest specificity and negative predictive value. Furthermore, the AUC, sensitivity, specificity, and accuracy of ACR TI-RADS, K-TIRADS, and C-TIRADS were higher in nodules >1 cm than in those ≤ 1 cm.”ConclusionAll three TI-RADS systems have diagnostic value in differentiating benign from malignant Bethesda III/IV nodules, With C-TIRADS showing the highest area under the curve(AUC), suggesting its potential utility in clinical evaluation and management of such nodules, particularly in Chinese populations.
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spelling doaj-art-6167dec55fa84e07b0fb44866d0d455f2025-08-20T02:16:23ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2025-04-011510.3389/fonc.2025.15496461549646Retrospective study from a single center to comparison of diagnostic value of three thyroid imaging reporting and data systems in Bethesda III/IV thyroid nodulesJie Guo0Liang Du1Wenjuan Bi2Yuchen Liu3Cuiming Zhang4Cuiming Zhang5College of Medical Imaging, Shanxi Medical University, Taiyuan, Shanxi, ChinaCollege of Medical Imaging, Shanxi Medical University, Taiyuan, Shanxi, ChinaThe Second Hospital of Shanxi Medical University, Taiyuan, Shanxi, ChinaCollege of Medical Imaging, Shanxi Medical University, Taiyuan, Shanxi, ChinaThe Second Hospital of Shanxi Medical University, Taiyuan, Shanxi, ChinaPingshan Hospital, Southern Medical University, Shenzhen, Guangdong, ChinaObjectivesTo compare the diagnostic value of ACR Thyroid Imaging Reporting and Data System (TI-RADS), K-TIRADS, and C-TIRADS in Bethesda III/IV thyroid nodules.MethodsThis single-center retrospective study classified 80 Bethesda stage III/IV thyroid nodules from 80 patients between January 2020 and July 2023 according to three different systems. Diagnostic performance was evaluated using receiver operating characteristic curves, with histopathological diagnosis serving as the reference standard.ResultsOverall, 41/80 (51.2%) nodules were malignant and 39/80 (48.8%) were benign. The malignancy rates for Bethesda type III and IV nodules were 50.7% and 55.6%, respectively. The malignancy risk in thyroid nodules increased with higher TI-RADS categories (P<0.001). Optimal cutoff values for ACR-, K-, and C-TIRADS were categories 5, 5, and 4C, respectively. Area under the curve (AUC) for ACR-, K-, and C-TIRADS was 0.782, 0.767, and 0.842, respectively, with C-TIRADS showing a significantly higher AUC than ACR-TIRADS and K-TIRADS (all P<0.05). C-TIRADS demonstrated the highest sensitivity, accuracy, and positive predictive value, whereas ACR TI-RADS showed the highest specificity and negative predictive value. Furthermore, the AUC, sensitivity, specificity, and accuracy of ACR TI-RADS, K-TIRADS, and C-TIRADS were higher in nodules >1 cm than in those ≤ 1 cm.”ConclusionAll three TI-RADS systems have diagnostic value in differentiating benign from malignant Bethesda III/IV nodules, With C-TIRADS showing the highest area under the curve(AUC), suggesting its potential utility in clinical evaluation and management of such nodules, particularly in Chinese populations.https://www.frontiersin.org/articles/10.3389/fonc.2025.1549646/fullThyroid Imaging Reporting and Data System (TI-RADS)cytological diagnosisBethesda III/IVthyroid nodulesmalignancy
spellingShingle Jie Guo
Liang Du
Wenjuan Bi
Yuchen Liu
Cuiming Zhang
Cuiming Zhang
Retrospective study from a single center to comparison of diagnostic value of three thyroid imaging reporting and data systems in Bethesda III/IV thyroid nodules
Frontiers in Oncology
Thyroid Imaging Reporting and Data System (TI-RADS)
cytological diagnosis
Bethesda III/IV
thyroid nodules
malignancy
title Retrospective study from a single center to comparison of diagnostic value of three thyroid imaging reporting and data systems in Bethesda III/IV thyroid nodules
title_full Retrospective study from a single center to comparison of diagnostic value of three thyroid imaging reporting and data systems in Bethesda III/IV thyroid nodules
title_fullStr Retrospective study from a single center to comparison of diagnostic value of three thyroid imaging reporting and data systems in Bethesda III/IV thyroid nodules
title_full_unstemmed Retrospective study from a single center to comparison of diagnostic value of three thyroid imaging reporting and data systems in Bethesda III/IV thyroid nodules
title_short Retrospective study from a single center to comparison of diagnostic value of three thyroid imaging reporting and data systems in Bethesda III/IV thyroid nodules
title_sort retrospective study from a single center to comparison of diagnostic value of three thyroid imaging reporting and data systems in bethesda iii iv thyroid nodules
topic Thyroid Imaging Reporting and Data System (TI-RADS)
cytological diagnosis
Bethesda III/IV
thyroid nodules
malignancy
url https://www.frontiersin.org/articles/10.3389/fonc.2025.1549646/full
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