Can ACR TI-RADS predict the malignant risk of medullary thyroid cancer?
Objectives: This study aimed to evaluate the diagnostic performance for medullary thyroid cancer (MTC) based on the 2017 Thyroid Imaging Reporting and Data System by the American College of Radiology (ACR TI-RADS) guideline, and the ability to recommend fine needle aspiration (FNA) for MTC. Methods:...
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Elsevier
2025-03-01
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| Series: | Journal of Clinical & Translational Endocrinology |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2214623724000516 |
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| author | Ying Zhang Bei-Bei Ye Han-Xiang Wang Bo-Ji Liu Yun-Yun Liu Qing Wei Chuan Qin Yi-Feng Zhang |
| author_facet | Ying Zhang Bei-Bei Ye Han-Xiang Wang Bo-Ji Liu Yun-Yun Liu Qing Wei Chuan Qin Yi-Feng Zhang |
| author_sort | Ying Zhang |
| collection | DOAJ |
| description | Objectives: This study aimed to evaluate the diagnostic performance for medullary thyroid cancer (MTC) based on the 2017 Thyroid Imaging Reporting and Data System by the American College of Radiology (ACR TI-RADS) guideline, and the ability to recommend fine needle aspiration (FNA) for MTC. Methods: Fifty-six MTCs were included, and 168 benign thyroid nodules (BTNs) and 168 papillary thyroid nodules (PTCs) were matched according to age. Ultrasound (US) features were reviewed according to ACR TI-RADS. US, clinical features and diagnostic performance of cytology of MTC, BTN and PTC were compared. Multivariate logistic regression analysis was performed to assess independent variables to predict MTC. Results: Multivariate logistic regression showed that position, hypoechoic, AP/T ratio ≥ 0.9 and marked internal blood flow were independent predictors of MTC compared to BTN (P < 0.05) and nodule sizes, AP/T ratio < 1, smooth or ill-defined margin and marked internal blood flow were independent predictors of MTC compared to PTC (P < 0.05). The area under the receiver operating characteristic (ROC) curve (AUC) of MTC based on ACR TI-RADS was inferior to that of PTC (0.687 vs 0.823) (P < 0.001). The recommended rate of FNA for MTC and PTC was 55.4 and 88.7 % respectively. 8 of 14 MTCs with negative FNA results (Bethesda II) had abnormal calcitonin (Ctn) results. Conclusions: Based on the ACR TI-RADS classification, the malignant risk features of MTC were intermediate between BTN and PTC. The diagnostic efficacy of MTC and FNA recommendation rate were inferior to PTC. Ctn examination would reduce the FNA missed diagnosis of MTC. |
| format | Article |
| id | doaj-art-b8eec32405494632b3f9ff25a907d9bc |
| institution | OA Journals |
| issn | 2214-6237 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Clinical & Translational Endocrinology |
| spelling | doaj-art-b8eec32405494632b3f9ff25a907d9bc2025-08-20T02:00:46ZengElsevierJournal of Clinical & Translational Endocrinology2214-62372025-03-013910038010.1016/j.jcte.2024.100380Can ACR TI-RADS predict the malignant risk of medullary thyroid cancer?Ying Zhang0Bei-Bei Ye1Han-Xiang Wang2Bo-Ji Liu3Yun-Yun Liu4Qing Wei5Chuan Qin6Yi-Feng Zhang7Department of Ultrasound, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai 200072, PR China; Ultrasound Research and Education Institute, Clinical Research Center for Interventional Medicine, School of Medicine, Tongji University, PR China; Shanghai Engineering Research Center of Ultrasound Diagnosis and Treatment, National Clinical Research Center for Interventional Medicine, Shanghai 200072, PR China; Center of Minimally Invasive Treatment for Tumor, Department of Medical Ultrasound, Shanghai Tenth People’s Hospital, PR ChinaDepartment of Ultrasound, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai 200072, PR China; Ultrasound Research and Education Institute, Clinical Research Center for Interventional Medicine, School of Medicine, Tongji University, PR China; Shanghai Engineering Research Center of Ultrasound Diagnosis and Treatment, National Clinical Research Center for Interventional Medicine, Shanghai 200072, PR China; Center of Minimally Invasive Treatment for Tumor, Department of Medical Ultrasound, Shanghai Tenth People’s Hospital, PR ChinaDepartment of Ultrasound, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai 200072, PR China; Ultrasound Research and Education Institute, Clinical Research Center for Interventional Medicine, School of Medicine, Tongji University, PR China; Shanghai Engineering Research Center of Ultrasound Diagnosis and Treatment, National Clinical Research Center for Interventional Medicine, Shanghai 200072, PR China; Center of Minimally Invasive Treatment for Tumor, Department of Medical Ultrasound, Shanghai Tenth People’s Hospital, PR ChinaDepartment of Ultrasound, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai 200072, PR China; Ultrasound Research and Education Institute, Clinical Research Center for Interventional Medicine, School of Medicine, Tongji University, PR China; Shanghai Engineering Research Center of Ultrasound Diagnosis and Treatment, National Clinical Research Center for Interventional Medicine, Shanghai 200072, PR China; Center of Minimally Invasive Treatment for Tumor, Department of Medical Ultrasound, Shanghai Tenth People’s Hospital, PR ChinaDepartment of Ultrasound, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai 200072, PR China; Ultrasound Research and Education Institute, Clinical Research Center for Interventional Medicine, School of Medicine, Tongji University, PR China; Shanghai Engineering Research Center of Ultrasound Diagnosis and Treatment, National Clinical Research Center for Interventional Medicine, Shanghai 200072, PR China; Center of Minimally Invasive Treatment for Tumor, Department of Medical Ultrasound, Shanghai Tenth People’s Hospital, PR ChinaDepartment of Pathology, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai 200072, PR ChinaDepartment of Ultrasound, Karamay City Central Hospital, Xinjiang 834000, PR China; Department of Medical Ultrasound, Jinshan Hospital, Fudan University, Shanghai 201508, PR ChinaDepartment of Ultrasound, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai 200072, PR China; Ultrasound Research and Education Institute, Clinical Research Center for Interventional Medicine, School of Medicine, Tongji University, PR China; Shanghai Engineering Research Center of Ultrasound Diagnosis and Treatment, National Clinical Research Center for Interventional Medicine, Shanghai 200072, PR China; Center of Minimally Invasive Treatment for Tumor, Department of Medical Ultrasound, Shanghai Tenth People’s Hospital, PR China; Corresponding author at: Department of Medical Ultrasound, Shanghai Tenth People’s Hospital, Ultrasound Research and Education Institute, Tongji University School of Medicine, No. 301#, Middle Yanchang zhong Road, Shanghai 200072, PR China.Objectives: This study aimed to evaluate the diagnostic performance for medullary thyroid cancer (MTC) based on the 2017 Thyroid Imaging Reporting and Data System by the American College of Radiology (ACR TI-RADS) guideline, and the ability to recommend fine needle aspiration (FNA) for MTC. Methods: Fifty-six MTCs were included, and 168 benign thyroid nodules (BTNs) and 168 papillary thyroid nodules (PTCs) were matched according to age. Ultrasound (US) features were reviewed according to ACR TI-RADS. US, clinical features and diagnostic performance of cytology of MTC, BTN and PTC were compared. Multivariate logistic regression analysis was performed to assess independent variables to predict MTC. Results: Multivariate logistic regression showed that position, hypoechoic, AP/T ratio ≥ 0.9 and marked internal blood flow were independent predictors of MTC compared to BTN (P < 0.05) and nodule sizes, AP/T ratio < 1, smooth or ill-defined margin and marked internal blood flow were independent predictors of MTC compared to PTC (P < 0.05). The area under the receiver operating characteristic (ROC) curve (AUC) of MTC based on ACR TI-RADS was inferior to that of PTC (0.687 vs 0.823) (P < 0.001). The recommended rate of FNA for MTC and PTC was 55.4 and 88.7 % respectively. 8 of 14 MTCs with negative FNA results (Bethesda II) had abnormal calcitonin (Ctn) results. Conclusions: Based on the ACR TI-RADS classification, the malignant risk features of MTC were intermediate between BTN and PTC. The diagnostic efficacy of MTC and FNA recommendation rate were inferior to PTC. Ctn examination would reduce the FNA missed diagnosis of MTC.http://www.sciencedirect.com/science/article/pii/S2214623724000516Medullary thyroid carcinomaPapillary thyroid carcinomaACR TI-RADSFine needle aspirationUltrasound |
| spellingShingle | Ying Zhang Bei-Bei Ye Han-Xiang Wang Bo-Ji Liu Yun-Yun Liu Qing Wei Chuan Qin Yi-Feng Zhang Can ACR TI-RADS predict the malignant risk of medullary thyroid cancer? Journal of Clinical & Translational Endocrinology Medullary thyroid carcinoma Papillary thyroid carcinoma ACR TI-RADS Fine needle aspiration Ultrasound |
| title | Can ACR TI-RADS predict the malignant risk of medullary thyroid cancer? |
| title_full | Can ACR TI-RADS predict the malignant risk of medullary thyroid cancer? |
| title_fullStr | Can ACR TI-RADS predict the malignant risk of medullary thyroid cancer? |
| title_full_unstemmed | Can ACR TI-RADS predict the malignant risk of medullary thyroid cancer? |
| title_short | Can ACR TI-RADS predict the malignant risk of medullary thyroid cancer? |
| title_sort | can acr ti rads predict the malignant risk of medullary thyroid cancer |
| topic | Medullary thyroid carcinoma Papillary thyroid carcinoma ACR TI-RADS Fine needle aspiration Ultrasound |
| url | http://www.sciencedirect.com/science/article/pii/S2214623724000516 |
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