A. Ansaloni

E. Taliani

G. Brigante

M. L. Monzani

M. Simoni

Madeo

S. Kaleci

V. Rochira.

English

Archivio istituzionale della ricerca - Università di Modena e Reggio Emilia

	 	  	Downloaded from https://academic.oup.com/jes/issue/3/Supplement_1 by Endocrine Society Member Access 3 user on 22 June 2019Article NavigationMON-580 Diagnostic Accuracy of Di!erent ThyroidUltrasound Classification Systems and the Added Valueof Operator Subjective Impression in Stratifying NoduleRisk Bruno Madeo, MD, PhD, Giulia Brigante, PhD, MD, Anna Ansaloni, MD, Erica Taliani, MD,Shaniko Kaleci, PhD, Maria Laura Monzani, MD, Manuela Simoni, MD, PhD,Vincenzo Rochira, MD, PhDJournal of the Endocrine Society, Volume 3, Issue Supplement_1, April-May 2019, MON-580,https://doi.org/10.1210/js.2019-MON-580Published:  30 April 2019AbstractSplit View Cite Permissions Share Background and aim. Several ultrasound (US) classifications for thyroid nodules havebeen proposed. Since most of them are hardly applicable in clinical practice, we set upthe Modena US Thyroid Classification (MUT) that stratifies the risk of malignancybased on knowledge derived from scientific literature and on clinician subjectiveimpression. The aim of the present study was to test the diagnostic accuracy ofdi!erent thyroid US classification systems, AACE/ACE-AME, American ThyroidAssociation (ATA), British Thyroid Association (BTA), and MUT, and to evaluate inter-classification agreement. Methods. We prospectively enrolled 111 patients (33M, 78F;age 19-75) with indeterminate, suspicious or malignant cytology. All the patientsunderwent neck US before surgery and a score according to MUT was assigned: 1 notcertainly nodular; 2 not suspect; 3 indeterminate; 4 suspect; 5 very suspect. Then, weretrospectively classified nodules according to AACE/ACE-AME, ATA and BTA. US  View MetricsEmail alertsNew issue alertIn progress issue alertAdvance article alertsArticle activity alertReceive exclusive o!ers and updatesIssue Section:  Thyroid and Thyroid Nodule Imaging and Cancer Risk StratificationCopyright © 2019 Endocrine SocietyThis article has been published under the terms of the Creative Commons Attribution Non-Commercial, No-Derivatives License (CC BY-NC-ND; https://creativecommons.org/licenses/by-nc-nd/4.0/).pattern was related to hystology. Sensitivity, specificity, diagnostic cut-o! value andaccuracy of each classification were calculated. The overall agreement betweenclassifications was quantified by Bland-Altman test. The agreement between singlenodule analysis by di!erent classifications was evaluated considering WeightedCohen's Kappa. Results. Fifteen patients had uninodular and 96 multinodular goiter,for a total of 457 nodules. MUT has the highest accuracy (AUC 0.808) and specificity(89%), followed by ATA and BTA, and finally by AACE/ACE-AME. ATA and BTA arehighly interchangeable and MUT is comparable to both of them. AACE/ACE-AME is theleast interchangeable with all the other classifications. Considering agreementbetween single nodule analysis by di!erent classifications, ATA and BTA had the best(k=0.723); AACE/ACE-AME showed slight agreement with BTA (k=0.177) and MUT(k=0.183), and fair agreement with ATA (k=0.282); MUT had fair agreement with bothATA (k=0.291) and BTA (k=0.271). Conclusions. Our findings bring out the limit inspecificity of the current reference classifications, which improves when thesubjective impression of the clinician is considered.

Diagnostic Accuracy of Different Thyroid Ultrasound Classification Systems and the Added Value of Operator Subjective Impression in Stratifying Nodule Risk

https://iris.unimore.it/bitstream/11380/1199420/1/0160_Madeo_et_al_MON-580_JES_ENDO_2019_New_Orleans.pdf

Diagnostic Accuracy of Different Thyroid Ultrasound Classification Systems and the Added Value of Operator Subjective Impression in Stratifying Nodule Risk

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