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Objective:To validate the Chinese version of Thyroid Imaging Report and Data System (C-TIRADS) for the malignancy risk stratification assessment of thyroid nodules, and compare with the American College of Radiology TIRADS(ACR-TIRADS) for diagnostic performance.Methods:A total of 1 306 patients with 1 389 thyroid nodules in the First Affiliated Hospital of Hainan Medical University from January 2015 to March 2021 were reviewed and assessed for diagnostic performance according to the C-TIRADS and the ACR-TIRADS, respectively, and the histopathological results were taken as golden standard.Results:The 1 389 thyroid nodules consisted of 973 benign nodules and 416 malignant nodules. The C-TIRADS 4C and ACR-TIRADS 5 had the highest accuracies and were taken respectively as the optimized cut-off values for diagnosis.The sensitivity, specificity, positive and negative predictive values and AUC by C-TIRADS 4C and ACR-TIRADS 5 for thyroid nodule evaluation were 87.39%, 89.92%, 75.00%, 95.38%, 0.89, and 85.58%, 91.88%, 81.84%, 93.71%, 0.89, respectively(all P>0.05). Conclusions:The C-TIRADS and ACR-TIRADS have good diagnostic performance for the malignancy risk stratification of thyroid nodules, and C-TIRADS 4C has comparable diagnostic performance to ACR-TIRADS 5.
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Objective: To establish ultrasonographic (US) classification criterion for evaluating malignant risk of cervical enlarged lymph nodes (LN). Methods: Four US indexes of 882 cervical enlarged LN were retrospectively studied, including echogenicity of hilum, intranodal echogenicity, intranodal vascular pattern and the ratio of long axis to short axis (L/S),and each LN was given scores. US classification criterion was proposed according to the differences of the percentage of malignant LN in each score group. Results: The score range of US criterion was from 0 to 7. The percentage of malignant LN increased with the scores increasing (P<0.05), so did OR values of malignant risk. US classification diagnostic criterion for cervical enlarged LN was as follows: grade 1 (0 score), very low malignant risk, malignant percentage was less than 3.70%; grade 2 (1-2 score), low malignant risk, malignant percentage was (14.91±4.63)%; grade 3 (3-4 score ), moderate malignant risk, malignant percentage was (43.89±0.64)%; grade 4 (5-7 score), high malignant risk, malignant percentage was (77.84±9.15)%. Taken "grade 4" as the cut-off value for differentiating benign and malignant LN, the sensitivity was 78.97%, specificity was 72.51%, Youden's index was 0.515,accuracy was 76.08%, and the AUC was 0.791. Conclusion: US classification based on US score criterion can differentiate benign and malignant LN and evaluate the malignant risk of cervical enlarged LN.
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BACKGROUND/AIMS: The accurate preoperative prediction of the risk of malignancy of gastrointestinal stromal tumors (GISTs) is difficult. The aim of this study was to determine whether tumor size and endoscopic ultrasonography (EUS) features can preoperatively predict the risk of malignancy of medium-sized gastric GISTs. METHODS: Surgically resected, 2 to 5 cm gastric GIST patients were enrolled and retrospectively reviewed. EUS features, such as heterogeneity, hyperechoic foci, calcification, cystic change, hypoechoic foci, lobulation, and ulceration, were evaluated. Tumors were grouped in 1 cm intervals. The correlations of tumor size or EUS features with the risk of malignancy were evaluated. RESULTS: A total of 75 patients were enrolled. The mean tumor size was 3.43+/-0.92 cm. Regarding the risk of malignancy, 51 tumors (68%) had a very low risk, and 24 tumors (32%) had a moderate risk. When the tumors were divided into three groups in 1 cm intervals, the proportions of tumors with a moderate risk were not different between the groups. The preoperative EUS features also did not differ between the very low risk and the moderate risk groups. CONCLUSIONS: Tumor size and EUS features cannot be used to preoperatively predict the risk of malignancy of medium-sized gastric GISTs. A preoperative diagnostic modality for predicting risk of malignancy is necessary to prevent the overtreatment of GISTs with a low risk of malignancy.