C-TIRADS shows comparable diagnostic performance to Kwak TI-RADS for thyroid malignancy

C-TIRADS ≥4B yielded 75.7% sensitivity, 75.8% specificity (AUC 0.784) for thyroid malignancy—not significantly different from Kwak TI-RADS (P>0.05) in 272 surgically confirmed cases (retrospective).

• Single-center retrospective cohort with 272 surgically confirmed nodules (173 malignant); two blinded readers graded using both systems.
• Longitudinal analysis showed increasing microcalcifications, irregular margins, taller-than-wide shape, and internal vascularity over follow-up.
• Limitations include retrospective design, selection bias from surgical confirmation/stable imaging criteria, and single-center setting.

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