The ultrasound risk stratification systems for thyroid nodule have been evaluated against papillary carcinoma

Trimboli, Pierpaolo; Castellana, Marco; Piccardo, Arnoldo; Romanelli, Francesco; Grani, Giorgio; Giovanella, Luca; Durante, Cosimo

doi:10.1007/s11154-020-09592-3

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Journal article

The ultrasound risk stratification systems for thyroid nodule have been evaluated against papillary carcinoma : a meta-analysis

Trimboli, Pierpaolo Clinic for Nuclear Medicine and Competence Center for Thyroid Diseases, Imaging Institute of Southern Switzerland, Ente Ospedaliero Cantonale, Bellinzona, Switzerland - Faculty of Biomedical Sciences, Università della Svizzera italiana, Switzerland
Castellana, Marco National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, Castellana Grotte, Bari, Italy
Piccardo, Arnoldo Department of Nuclear Medicine, Galliera Hospital, Genoa, Italy
Romanelli, Francesco Department of Experimental Medicine, “Sapienza” University of Rome, Italy
Grani, Giorgio Department of Translational and Precision Medicine, Sapienza University of Rome, Italy
Giovanella, Luca Clinic for Nuclear Medicine and Competence Center for Thyroid Diseases, Imaging Institute of Southern Switzerland, Ente Ospedaliero Cantonale, Bellinzona, Switzerland - Clinic for Nuclear Medicine, University Hospital and University of Zurich, Switzerland
Durante, Cosimo Department of Translational and Precision Medicine, Sapienza University of Rome, Italy

21.09.2020

Published in:

Reviews in endocrine and metabolic disorders. - 2021, vol. 22, p. 453–460

English Thyroid imaging reporting and data systems (TIRADS) are used to stratify the malignancy risk of thyroid nodule by ultrasound (US) examination. We conducted a meta-analysis to evaluate the pooled cancer prevalence and the relative prevalence of papillary, medullary, follicular thyroid cancer (PTC, MTC, and FTC) and other malignancies among nodules included in studies evaluating their performance. Four databases were searched until February 2020. Original articles with at least 1000 nodules, evaluating the performance of at least one TIRADS among AACE/ACE/AME, ACR-TIRADS, ATA, EU-TIRADS, or K-TIRADS, and reporting data on the histological diagnosis of malignant lesions were included. The number of malignant nodules, PTC, FTC, MTC and other malignancies in each study was extracted. For statistical pooling of data, a random-effects model was used. Nine studies were included, evaluating 19,494 thyroid nodules. The overall prevalence of malignancy was 34% (95%CI 21 to 49). Among 6162 histologically proven malignancies, the prevalence of PTC, FTC, MTC and other malignancies was 95%, 2%, 1%, and 1%, respectively. A high heterogeneity was found for all the outcomes. A limited number of studies generally conducted using a retrospective design was found, with possible selection bias. Acknowledging this limitation, TIRADSs should be regarded as accurate tools to diagnose PTC only. Proposed patterns and/or cut-offs should be revised and other strategies considered to improve their performance in the assessment of FTC, MTC and other malignancies.

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