Consistency of Thyroid Imaging Reporting and Data System Reporting in Community-Based Imaging Centers Versus a Large Tertiary Hospital |
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Authors: | Rena Pollack Noam Koch Haggi Mazeh Avivit Cahn Lilach Katz Liat Appelbaum |
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Institution: | 1. Department of Endocrinology and Metabolism, Hadassah Medical Center, Jerusalem, Israel;2. The Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel;3. Department of Surgery, Hadassah Medical Center, Jerusalem, Israel;4. Clalit Health Services, Jerusalem, Israel;5. Department of Radiology, Hadassah Medical Center, Jerusalem, Israel |
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Abstract: | ObjectiveIn our country, thyroid nodules are sonographically evaluated in health maintenance organization (HMO) imaging centers, and patients are referred to tertiary hospitals for ultrasound-guided fine-needle aspiration (FNA) biopsy when indicated. We evaluated the concordance in Thyroid Imaging Reporting and Data System (TI-RADS) classification reporting between these sites.MethodsWe conducted a retrospective cohort study reviewing the sonographic features of thyroid nodules evaluated both at the HMO and a large tertiary center between January 2018 and December 2019. The primary outcome was concordance between the TI-RADS classification at both sites. Additional endpoints included correlation of TI-RADS to the Bethesda category following FNA and correlation of TI-RADS with malignancy on final pathology at each site.ResultsThe records of 336 patients with 370 nodules were reviewed. The level of concordance was poor (19.8%), with 277 (74.8%) nodules demonstrating higher TI-RADS and 20 (5.4%) lower TI-RADS at the HMO compared to the hospital (P < .001; weighted κ = 0.120). FNA results were available for 236 (63.8%) nodules. The Bethesda category strongly correlated with the hospital TI-RADS (P < .001), yet not with HMO TI-RADS (P = .123). In the surgically removed 57 nodules, a strong correlation was identified between the malignancy on final pathology and TI-RADS documented at the hospital (P < .001), yet not at the HMO (P = .259).ConclusionsThere is poor agreement between TI-RADS classification on ultrasound performed in the HMO compared to a tertiary hospital. The hospital’s TI-RADS strongly correlated with the Bethesda category and the final risk of malignancy, unlike the HMO. |
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Keywords: | thyroid nodule thyroid ultrasound TI-RADS interobserver variability ACR"} {"#name":"keyword" "$":{"id":"kwrd0035"} "$$":[{"#name":"text" "_":"American College of Radiology FNA"} {"#name":"keyword" "$":{"id":"kwrd0045"} "$$":[{"#name":"text" "_":"fine-needle aspiration HMO"} {"#name":"keyword" "$":{"id":"kwrd0055"} "$$":[{"#name":"text" "_":"health maintenance organization PTC"} {"#name":"keyword" "$":{"id":"kwrd0065"} "$$":[{"#name":"text" "_":"papillary thyroid carcinoma TI-RADS"} {"#name":"keyword" "$":{"id":"kwrd0075"} "$$":[{"#name":"text" "_":"Thyroid Imaging Reporting and Data System US"} {"#name":"keyword" "$":{"id":"kwrd0085"} "$$":[{"#name":"text" "_":"ultrasound |
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