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      Reproducibility and Interobserver Agreement of Different Thyroid Imaging and Reporting Data Systems (TIRADS)

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          Introduction: A number of classification systems (TIRADS) have been developed to estimate the likelihood of malignancy in thyroid nodules, but their reproducibility is yet to be assessed. We evaluated the interobserver variability and diagnostic performance of the TIRADS in Kwak’s modification (Kw-TIRADS) and European TIRADS (EU-TIRADS). Methods: Two independent specialists, blinded concerning the morphology of the nodules, evaluated ultrasound images of 153 thyroid nodules identified in 149 patients at multiple time points. Results: The interobserver agreement (Cohen’s κ) was 0.52 and 0.67 for Kw-TIRADS and EU-TIRADS, respectively, and rated as substantial. There were strong correlations between Kw-TIRADS and EU-TIRADS for the two observers with Spearman’s coefficients of 0.731 ( p = 0.00025) and 0.661 ( p = 0.0012), respectively. Sensitivity of Kw-TIRADS for the diagnosis of thyroid cancer was 95–92.31% and that of EU-TIRADS was 92.31–89.74%, with specificity of about 60% for both TIRADS. Conclusion: Despite the wide variability in the description of single ultrasonographic features, both Kw-TIRADS and EU-TIRADS may be a useful diagnostic tool in clinical practice.

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          The Measurement of Observer Agreement for Categorical Data

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            European Thyroid Association Guidelines for Ultrasound Malignancy Risk Stratification of Thyroid Nodules in Adults: The EU-TIRADS

            Thyroid ultrasound (US) is a key examination for the management of thyroid nodules. Thyroid US is easily accessible, noninvasive, and cost-effective, and is a mandatory step in the workup of thyroid nodules. The main disadvantage of the method is that it is operator dependent. Thyroid US assessment of the risk of malignancy is crucial in patients with nodules, in order to select those who should have a fine needle aspiration (FNA) biopsy performed. Due to the pivotal role of thyroid US in the management of patients with nodules, the European Thyroid Association convened a panel of international experts to set up European guidelines on US risk stratification of thyroid nodules. Based on a review of the literature and on the American Association of Clinical Endocrinologists, American Thyroid Association, and Korean guidelines, the panel created the novel European Thyroid Imaging and Reporting Data System, called EU-TIRADS. This comprises a thyroid US lexicon; a standardized report; definitions of benign and low-, intermediate-, and high-risk nodules, with the estimated risks of malignancy in each category; and indications for FNA. Illustrated by numerous US images, the EU-TIRADS aims to serve physicians in their clinical practice, to enhance the interobserver reproducibility of descriptions, and to simplify communication of the results.
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              Biologic and Clinical Perspectives on Thyroid Cancer


                Author and article information

                European Thyroid Journal
                S. Karger AG
                April 2021
                17 September 2020
                : 10
                : 2
                : 161-167
                aDepartment of Endocrinology 1 at I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Moscow, Russian Federation
                bLaboratory of Ultrasound Diagnostics, Federal State Research Institution “B.V. Petrovsky National Research Centre of Surgery”, Moscow, Russian Federation
                Author notes
                *Yulia P. Sych, Department of Endocrinology 1, I.M. Sechenov First Moscow State Medical, University of the Ministry of Health of the Russian Federation (Sechenov University), Trubetskaya ul., 8, bld.2., Moscow 119991 (Russian Federation), juliasytch@mail.ru
                508959 Eur Thyroid J 2021;10:161–167
                © 2020 The Author(s) Published by S. Karger AG, Basel

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                Page count
                Figures: 1, Tables: 4, Pages: 7
                Clinical Thyroidology / Research Article


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