Interobserver agreement of Thyroid Imaging Reporting and Data System (TIRADS) and strain elastography for the assessment of thyroid nodules
Thyroid Imaging Reporting and Data System (TIRADS) was developed to improve patient management and cost-effectiveness by avoiding unnecessary fine needle aspiration biopsy (FNAB) in patients with thyroid nodules. However, its clinical use is still very limited. Strain elastography (SE) enables the d...
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| creator | Friedrich-Rust, Mireen Meyer, Gesine Dauth, Nina Berner, Christian Bogdanou, Dimitra Herrmann, Eva Zeuzem, Stefan Bojunga, Joerg |
| description | Thyroid Imaging Reporting and Data System (TIRADS) was developed to improve patient management and cost-effectiveness by avoiding unnecessary fine needle aspiration biopsy (FNAB) in patients with thyroid nodules. However, its clinical use is still very limited. Strain elastography (SE) enables the determination of tissue elasticity and has shown promising results for the differentiation of thyroid nodules.
The aim of the present study was to evaluate the interobserver agreement (IA) of TIRADS developed by Horvath et al. and SE. Three blinded observers independently scored stored images of TIRADS and SE in 114 thyroid nodules (114 patients). Cytology and/or histology was available for all benign (n = 99) and histology for all malignant nodules (n = 15).
The IA between the 3 observers was only fair for TIRADS categories 2-5 (Coheńs kappa = 0.27,p = 0.000001) and TIRADS categories 2/3 versus 4/5 (ck = 0.25,p = 0.0020). The IA was substantial for SE scores 1-4 (ck = 0.66,p |
| doi_str_mv | 10.1371/journal.pone.0077927 |
| format | Article |
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The aim of the present study was to evaluate the interobserver agreement (IA) of TIRADS developed by Horvath et al. and SE. Three blinded observers independently scored stored images of TIRADS and SE in 114 thyroid nodules (114 patients). Cytology and/or histology was available for all benign (n = 99) and histology for all malignant nodules (n = 15).
The IA between the 3 observers was only fair for TIRADS categories 2-5 (Coheńs kappa = 0.27,p = 0.000001) and TIRADS categories 2/3 versus 4/5 (ck = 0.25,p = 0.0020). The IA was substantial for SE scores 1-4 (ck = 0.66,p<0.000001) and very good for SE scores 1/2 versus 3/4 (ck = 0.81,p<0.000001). 92-100% of patients with TIRADS-2 had benign lesions, while 28-42% with TIRADS-5 had malignant cytology/histology. The negative-predictive-value (NPV) was 92-100% for TIRADS using TIRADS-categories 4&5 and 96-98% for SE using score ES-3&4 for the diagnosis of malignancy, respectively. However, only 11-42% of nodules were in TIRADS-categories 2&3, as compared to 58-60% with ES-1&2.
IA of TIRADS developed by Horvath et al. is only fair. TIRADS and SE have high NPV for excluding malignancy in the diagnostic work-up of thyroid nodules.]]></description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0077927</identifier><identifier>PMID: 24205031</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Benign ; Biopsy ; Categories ; Cellular biology ; Clinical medicine ; Cytology ; Diagnostic systems ; Elasticity ; Histology ; Humans ; Internal medicine ; Lesions ; Malignancy ; Medical diagnosis ; Medicine ; Nodules ; Observers ; Patients ; Strain ; Surgery ; Thyroid ; Thyroid cancer ; Thyroid Neoplasms - diagnostic imaging ; Thyroid Nodule - diagnostic imaging ; Ultrasonography</subject><ispartof>PloS one, 2013-10, Vol.8 (10), p.e77927-e77927</ispartof><rights>2013 Friedrich-Rust et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License: https://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2013 Friedrich-Rust et al 2013 Friedrich-Rust et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c526t-b0ab1607a1096e3d105f9993ad1b1abf97ffee4a74d2e56f491451a0e8a226793</citedby><cites>FETCH-LOGICAL-c526t-b0ab1607a1096e3d105f9993ad1b1abf97ffee4a74d2e56f491451a0e8a226793</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3812025/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3812025/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2095,2914,23846,27903,27904,53770,53772,79347,79348</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24205031$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Hendrikse, Jeroen</contributor><creatorcontrib>Friedrich-Rust, Mireen</creatorcontrib><creatorcontrib>Meyer, Gesine</creatorcontrib><creatorcontrib>Dauth, Nina</creatorcontrib><creatorcontrib>Berner, Christian</creatorcontrib><creatorcontrib>Bogdanou, Dimitra</creatorcontrib><creatorcontrib>Herrmann, Eva</creatorcontrib><creatorcontrib>Zeuzem, Stefan</creatorcontrib><creatorcontrib>Bojunga, Joerg</creatorcontrib><title>Interobserver agreement of Thyroid Imaging Reporting and Data System (TIRADS) and strain elastography for the assessment of thyroid nodules</title><title>PloS one</title><addtitle>PLoS One</addtitle><description><![CDATA[Thyroid Imaging Reporting and Data System (TIRADS) was developed to improve patient management and cost-effectiveness by avoiding unnecessary fine needle aspiration biopsy (FNAB) in patients with thyroid nodules. However, its clinical use is still very limited. Strain elastography (SE) enables the determination of tissue elasticity and has shown promising results for the differentiation of thyroid nodules.
The aim of the present study was to evaluate the interobserver agreement (IA) of TIRADS developed by Horvath et al. and SE. Three blinded observers independently scored stored images of TIRADS and SE in 114 thyroid nodules (114 patients). Cytology and/or histology was available for all benign (n = 99) and histology for all malignant nodules (n = 15).
The IA between the 3 observers was only fair for TIRADS categories 2-5 (Coheńs kappa = 0.27,p = 0.000001) and TIRADS categories 2/3 versus 4/5 (ck = 0.25,p = 0.0020). The IA was substantial for SE scores 1-4 (ck = 0.66,p<0.000001) and very good for SE scores 1/2 versus 3/4 (ck = 0.81,p<0.000001). 92-100% of patients with TIRADS-2 had benign lesions, while 28-42% with TIRADS-5 had malignant cytology/histology. The negative-predictive-value (NPV) was 92-100% for TIRADS using TIRADS-categories 4&5 and 96-98% for SE using score ES-3&4 for the diagnosis of malignancy, respectively. However, only 11-42% of nodules were in TIRADS-categories 2&3, as compared to 58-60% with ES-1&2.
IA of TIRADS developed by Horvath et al. is only fair. TIRADS and SE have high NPV for excluding malignancy in the diagnostic work-up of thyroid nodules.]]></description><subject>Benign</subject><subject>Biopsy</subject><subject>Categories</subject><subject>Cellular biology</subject><subject>Clinical medicine</subject><subject>Cytology</subject><subject>Diagnostic systems</subject><subject>Elasticity</subject><subject>Histology</subject><subject>Humans</subject><subject>Internal medicine</subject><subject>Lesions</subject><subject>Malignancy</subject><subject>Medical diagnosis</subject><subject>Medicine</subject><subject>Nodules</subject><subject>Observers</subject><subject>Patients</subject><subject>Strain</subject><subject>Surgery</subject><subject>Thyroid</subject><subject>Thyroid cancer</subject><subject>Thyroid Neoplasms - diagnostic imaging</subject><subject>Thyroid Nodule - diagnostic 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agreement of Thyroid Imaging Reporting and Data System (TIRADS) and strain elastography for the assessment of thyroid nodules</title><author>Friedrich-Rust, Mireen ; Meyer, Gesine ; Dauth, Nina ; Berner, Christian ; Bogdanou, Dimitra ; Herrmann, Eva ; Zeuzem, Stefan ; Bojunga, Joerg</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c526t-b0ab1607a1096e3d105f9993ad1b1abf97ffee4a74d2e56f491451a0e8a226793</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Benign</topic><topic>Biopsy</topic><topic>Categories</topic><topic>Cellular biology</topic><topic>Clinical medicine</topic><topic>Cytology</topic><topic>Diagnostic systems</topic><topic>Elasticity</topic><topic>Histology</topic><topic>Humans</topic><topic>Internal medicine</topic><topic>Lesions</topic><topic>Malignancy</topic><topic>Medical diagnosis</topic><topic>Medicine</topic><topic>Nodules</topic><topic>Observers</topic><topic>Patients</topic><topic>Strain</topic><topic>Surgery</topic><topic>Thyroid</topic><topic>Thyroid cancer</topic><topic>Thyroid Neoplasms - diagnostic imaging</topic><topic>Thyroid Nodule - diagnostic imaging</topic><topic>Ultrasonography</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Friedrich-Rust, Mireen</creatorcontrib><creatorcontrib>Meyer, Gesine</creatorcontrib><creatorcontrib>Dauth, Nina</creatorcontrib><creatorcontrib>Berner, Christian</creatorcontrib><creatorcontrib>Bogdanou, Dimitra</creatorcontrib><creatorcontrib>Herrmann, Eva</creatorcontrib><creatorcontrib>Zeuzem, Stefan</creatorcontrib><creatorcontrib>Bojunga, Joerg</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE 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assessment of thyroid nodules</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2013-10-24</date><risdate>2013</risdate><volume>8</volume><issue>10</issue><spage>e77927</spage><epage>e77927</epage><pages>e77927-e77927</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract><![CDATA[Thyroid Imaging Reporting and Data System (TIRADS) was developed to improve patient management and cost-effectiveness by avoiding unnecessary fine needle aspiration biopsy (FNAB) in patients with thyroid nodules. However, its clinical use is still very limited. Strain elastography (SE) enables the determination of tissue elasticity and has shown promising results for the differentiation of thyroid nodules.
The aim of the present study was to evaluate the interobserver agreement (IA) of TIRADS developed by Horvath et al. and SE. Three blinded observers independently scored stored images of TIRADS and SE in 114 thyroid nodules (114 patients). Cytology and/or histology was available for all benign (n = 99) and histology for all malignant nodules (n = 15).
The IA between the 3 observers was only fair for TIRADS categories 2-5 (Coheńs kappa = 0.27,p = 0.000001) and TIRADS categories 2/3 versus 4/5 (ck = 0.25,p = 0.0020). The IA was substantial for SE scores 1-4 (ck = 0.66,p<0.000001) and very good for SE scores 1/2 versus 3/4 (ck = 0.81,p<0.000001). 92-100% of patients with TIRADS-2 had benign lesions, while 28-42% with TIRADS-5 had malignant cytology/histology. The negative-predictive-value (NPV) was 92-100% for TIRADS using TIRADS-categories 4&5 and 96-98% for SE using score ES-3&4 for the diagnosis of malignancy, respectively. However, only 11-42% of nodules were in TIRADS-categories 2&3, as compared to 58-60% with ES-1&2.
IA of TIRADS developed by Horvath et al. is only fair. TIRADS and SE have high NPV for excluding malignancy in the diagnostic work-up of thyroid nodules.]]></abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>24205031</pmid><doi>10.1371/journal.pone.0077927</doi><oa>free_for_read</oa></addata></record> |
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| subjects | Benign Biopsy Categories Cellular biology Clinical medicine Cytology Diagnostic systems Elasticity Histology Humans Internal medicine Lesions Malignancy Medical diagnosis Medicine Nodules Observers Patients Strain Surgery Thyroid Thyroid cancer Thyroid Neoplasms - diagnostic imaging Thyroid Nodule - diagnostic imaging Ultrasonography |
| title | Interobserver agreement of Thyroid Imaging Reporting and Data System (TIRADS) and strain elastography for the assessment of thyroid nodules |
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