Explore the Diagnostic Performance of 2020 C-TIRADS by Comparing With the 2017 ACR-TIRADS guidelines: A Single-Center Study

Abstract Objective To compare the diagnostic efficacy of the Chinese Thyroid Imaging Reporting and Data Systems(C-TIRADS) with the well-accepted ACR-TIRADS guidelines in identifying benign from malignant thyroid nodules. Methods A total of 2064 nodules were collected from 1627 patients undergoing thyroid ultrasonography in our center between October 2019 to November 2021. Nodules were divided into two groups: “≥1cm”and “<1cm”. Ultrasound features of each nodule were observed and recorded by 2 physicians and classified according to the ACR-TIRADS and C-TIRADS guidelines, respectively. Results The area under the curve(AUC) of the ACR-TIRADS guideline was higher than that of the C-TIRADS guideline(0.922, P = 0.017), the specificity and positive predictive value of the C-TIRADS guideline were higher (81.64%, 88.72%, all P < 0.05). The diagnostic performance showed similar results for nodules < 1cm. Additionally, the diagnostic efficacy of both guidelines was comparable in nodules ≥ 1cm. The ACR-TIRADS effectively reduced unnecessary biopsies compared with the C-TIRADS (P < 0.05). Conclusions There was high agreement between two guidelines for the diagnosis of thyroid nodules, C-TIRADS guidelines had a higher specificity and simplicity while were inferior to the ACR-TIRADS guidelines in terms of reducing the number of biopsies.