Modified ACR TI-RADS with contrast-enhanced ultrasound and nodule location improves diagnosis and biopsy decisions for TR4 or higher thyroid nodules

Adding contrast-enhanced ultrasound features and nodule location to American College of Radiology TI-RADS raised the area under the curve from 0.75 to 0.90 and sensitivity from 60.3% to 88.5% for TR4 or higher thyroid nodules, cutting unnecessary biopsy rate from 50.6% to 32.9%

• In the training set of 334 nodules, the modified system achieved AUC 0.90 (95% CI 0.86-0.93) versus 0.75 (95% CI 0.71-0.79) and sensitivity 88.5% versus 60.3% (p < .01).
• Temporal validation in 108 nodules showed similar gains: AUC 0.95 (95% CI 0.90-0.99) versus 0.73 (95% CI 0.66-0.79), sensitivity 87.0% versus 49.3%, and benign biopsy rate 5.1% versus 17.9%, with no unsafe downgrading.
• Independent predictors were enhancement intensity, enhancement direction, ring enhancement, enhancement area, and nodule location.

Automated summary

RadPigeon summaries are original and for information only. They are not clinical advice.