A new scoring system for risk stratification of thyroid tumors

Abstract Objectives To develop an ultrasound feature–based risk stratification system for differentiating benign, low-risk and malignant thyroid tumors and compare it with existing TI-RADS. Methods The retrospective study included patients who underwent preoperative neck ultrasound examination from...

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Main Authors: Ya Yuan, Hua Shu, Lu Li, Liuxi Wu, Fei Yu
Format: Article
Language:English
Published: BMC 2025-04-01
Series:BMC Medical Imaging
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Online Access:https://doi.org/10.1186/s12880-025-01633-0
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author Ya Yuan
Hua Shu
Lu Li
Liuxi Wu
Fei Yu
author_facet Ya Yuan
Hua Shu
Lu Li
Liuxi Wu
Fei Yu
author_sort Ya Yuan
collection DOAJ
description Abstract Objectives To develop an ultrasound feature–based risk stratification system for differentiating benign, low-risk and malignant thyroid tumors and compare it with existing TI-RADS. Methods The retrospective study included patients who underwent preoperative neck ultrasound examination from January 2018 to June 2023, and their ultrasound characteristics were recorded. According to surgical pathological findings, they were classified into three categories: benign, low-risk, and malignant. Univariable and multivariable logistic regression analyses were used to assess the association of qualitative ultrasound features with different risk stratifications and a new scoring system was established to evaluate its diagnostic efficacy, and to compare it with TI-RADS. Results Aspect ratio ≥1 was an independent risk factor in the comparison of benign and low-risk thyroid nodules, and in the comparison of benign and malignant nodules, hypoechoic,irregular margin,nodule max diameter ≤1 cm,the aspect ratio ≥1 and elasticity score ≥3 were independent risk factors. According to the multivariate analysis, they were assigned 1, 2, 2, 3, 2/4 points respectively, and we established a new scoring system. According to ROC analysis, the total score of 0–4.5 was considered as benign nodules, 4.5–5.5 was considered as low-risk nodules, and more than 5.5 were considered as malignant nodules. Compared it to ACR-TI-RADS, this scoring system performed better than in differentiating benign and malignant nodules (P = 0.001, P = 0.018, respectively). Conclusion The scoring system based on ultrasound features established in this study can be used for risk stratification of thyroid nodules more efficiently, it has higher sensitivity and specificity for the differentiation of benign and malignant nodules.
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spelling doaj-art-8283be582a794c65be971c73b7fddee32025-08-20T02:28:04ZengBMCBMC Medical Imaging1471-23422025-04-012511910.1186/s12880-025-01633-0A new scoring system for risk stratification of thyroid tumorsYa Yuan0Hua Shu1Lu Li2Liuxi Wu3Fei Yu4Department of Ultrasound, The First Affiliated Hospital with Nanjing Medical UniversityDepartment of Ultrasound, The First Affiliated Hospital with Nanjing Medical UniversityDepartment of Ultrasound, The First Affiliated Hospital with Nanjing Medical UniversityDepartment of Ultrasound, Nanjing Drum Tower HospitalDepartment of Nuclear Medicine, Shanghai Tenth People’s Hospital with Nanjing Medical UniversityAbstract Objectives To develop an ultrasound feature–based risk stratification system for differentiating benign, low-risk and malignant thyroid tumors and compare it with existing TI-RADS. Methods The retrospective study included patients who underwent preoperative neck ultrasound examination from January 2018 to June 2023, and their ultrasound characteristics were recorded. According to surgical pathological findings, they were classified into three categories: benign, low-risk, and malignant. Univariable and multivariable logistic regression analyses were used to assess the association of qualitative ultrasound features with different risk stratifications and a new scoring system was established to evaluate its diagnostic efficacy, and to compare it with TI-RADS. Results Aspect ratio ≥1 was an independent risk factor in the comparison of benign and low-risk thyroid nodules, and in the comparison of benign and malignant nodules, hypoechoic,irregular margin,nodule max diameter ≤1 cm,the aspect ratio ≥1 and elasticity score ≥3 were independent risk factors. According to the multivariate analysis, they were assigned 1, 2, 2, 3, 2/4 points respectively, and we established a new scoring system. According to ROC analysis, the total score of 0–4.5 was considered as benign nodules, 4.5–5.5 was considered as low-risk nodules, and more than 5.5 were considered as malignant nodules. Compared it to ACR-TI-RADS, this scoring system performed better than in differentiating benign and malignant nodules (P = 0.001, P = 0.018, respectively). Conclusion The scoring system based on ultrasound features established in this study can be used for risk stratification of thyroid nodules more efficiently, it has higher sensitivity and specificity for the differentiation of benign and malignant nodules.https://doi.org/10.1186/s12880-025-01633-0Thyroid tumorsTI-RADSRisk stratification
spellingShingle Ya Yuan
Hua Shu
Lu Li
Liuxi Wu
Fei Yu
A new scoring system for risk stratification of thyroid tumors
BMC Medical Imaging
Thyroid tumors
TI-RADS
Risk stratification
title A new scoring system for risk stratification of thyroid tumors
title_full A new scoring system for risk stratification of thyroid tumors
title_fullStr A new scoring system for risk stratification of thyroid tumors
title_full_unstemmed A new scoring system for risk stratification of thyroid tumors
title_short A new scoring system for risk stratification of thyroid tumors
title_sort new scoring system for risk stratification of thyroid tumors
topic Thyroid tumors
TI-RADS
Risk stratification
url https://doi.org/10.1186/s12880-025-01633-0
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