Comparison among TIRADS (ACR TI-RADS and KWAK- TI-RADS) and 2015 ATA Guidelines in the diagnostic efficiency of thyroid nodules.
PURPOSE
To compare the value of Thyroid Imaging Reporting and Data Systems proposed by Kwak (KWAK-TIRADS) and ACR (ACR TI-RADS) and 2015 American Thyroid Association (ATA) guidelines in the diagnosis of surgically resected thyroid nodules.


METHODS
From January 2015 to December 2015, 2544 thyroid nodules in 1758 patients who underwent thyroidectomy at our center were included. The KWAK-TIRADS category, ACR TI-RADS and ultrasound (US) pattern based on ATA guidelines were assigned to each thyroid nodule. Nodules were divided into groups according to their maximal diameter further.


RESULTS
Of all the nodules, 863 (33.9%) were benign, whereas 1681 (66.1%) were malignant. The malignancy percentage of ACR TI-RADS category 1, 2, 3, 4, and 5 were 0%, 1.3%, 9.1%, 52.5%, and 88.8%, respectively. KWAK-TIRADS and ATA guidelines showed a better diagnostic efficiency than ACR TI-RADS (P < 0.01). ACR TI-RADS demonstrated a higher specificity (79.7%, P < 0.05), whereas the ATA US pattern had a higher sensitivity (95.5%, P < 0.01). The TIRADS (KWAK-TIRADS and ACR TI-RADS) category and ATA guidelines performed better in differentiating nodules >1 cm. KWAK-TIRADS showed better diagnostic efficiency than the other methods in differentiating nodules >1 cm (AUC: 0.92, P < 0.01).


CONCLUSIONS
KWAK-TIRADS and ATA guidelines provide a better diagnostic efficiency than ACR TI-RADS. The TIRADS (KWAK-TIRADS and ACR TI-RADS) category and ATA guidelines perform better in differentiating nodules >1 cm than nodules ≤1 cm. KWAK-TIRADS perform better in differentiating nodules >1 cm than other methods.
['Gao|Luying|L|', 'Xi|Xuehua|X|', 'Jiang|Yuxin|Y|', 'Yang|Xiao|X|', 'Wang|Ying|Y|', 'Zhu|Shenling|S|', 'Lai|Xingjian|X|', 'Zhang|Xiaoyan|X|', 'Zhao|Ruina|R|', 'Zhang|Bo|B|0000-0003-3389-5018']
D000328:Adult D005260:Female D006801:Humans D008297:Male D008875:Middle Aged D017410:Practice Guidelines as Topic D012189:Retrospective Studies D018570:Risk Assessment D012680:Sensitivity and Specificity D013961:Thyroid Gland D016606:Thyroid Nodule D013965:Thyroidectomy D014463:Ultrasonography D014481:United States
Thyroid nodules Thyroid Imaging Reporting and Data System Ultrasound 2015 American Thyroid Association management guideline