PMID- 32544875
OWN - NLM
STAT- MEDLINE
DCOM- 20200817
LR  - 20220415
IS  - 1479-683X (Electronic)
IS  - 0804-4643 (Linking)
VI  - 183
IP  - 3
DP  - 2020 Sep
TI  - Performance of EU-TIRADS in malignancy risk stratification of thyroid nodules: a 
      meta-analysis.
PG  - 255-264
LID - EJE-20-0204 [pii]
LID - 10.1530/EJE-20-0204 [doi]
AB  - OBJECTIVE: Several thyroid imaging reporting and data systems (TIRADS) have been 
      proposed to stratify the malignancy risk of thyroid nodule by ultrasound. The 
      TIRADS by the European Thyroid Association, namely EU-TIRADS, was the last one to 
      be published. DESIGN: We conducted a meta-analysis to assess the prevalence of 
      malignancy in each EU-TIRADS class and the performance of EU-TIRADS class 5 vs 2, 
      3 and 4 in detecting malignant lesions. METHODS: Four databases were searched 
      until December 2019. Original articles reporting the performance of EU-TIRADS and 
      adopting histology as reference standard were included. The number of malignant 
      nodules in each class and the number of nodules classified as true/false 
      positive/negative were extracted. A random-effects model was used for pooling 
      data. RESULTS: Seven studies were included, evaluating 5672 thyroid nodules. The 
      prevalence of malignancy in each EU-TIRADS class was 0.5% (95% CI: 0.0-1.3), 5.9% 
      (95% CI: 2.6-9.2), 21.4% (95% CI: 11.1-31.7), and 76.1% (95% CI: 63.7-88.5). 
      Sensitivity, specificity, PPV, NPV, LR+, LR- and DOR of EU-TIRADS class 5 were 
      83.5% (95% CI: 74.5-89.8), 84.3% (95% CI: 66.2-93.7), 76.1% (95% CI: 63.7-88.5), 
      85.4% (95% CI: 79.1-91.8), 4.9 (95% CI: 2.9-8.2), 0.2 (95% CI: 0.1-0.3), and 24.5 
      (95% CI: 11.7-51.0), respectively. A further improved performance was found after 
      excluding two studies because of limited sample size and low prevalence of 
      malignancy in class 5. CONCLUSIONS: A limited number of studies generally 
      conducted using a retrospective design was found. Acknowledging this limitation, 
      the performance of EU-TIRADS in stratifying the risk of thyroid nodules was high. 
      Also, EU-TIRADS class 5 showed moderate evidence of detecting malignant lesions.
FAU - Castellana, Marco
AU  - Castellana M
AD  - National Institute of Gastroenterology 'S. de Bellis', Research Hospital, 
      Castellana Grotte, Italy.
FAU - Grani, Giorgio
AU  - Grani G
AUID- ORCID: 0000-0002-0388-1283
AD  - Department of Translational and Precision Medicine, Sapienza University of Rome, 
      Rome, Italy.
FAU - Radzina, Maija
AU  - Radzina M
AD  - Diagnostic Radiology Institute, Paula Stradina Clinical University Hospital, 
      University of Latvia, Radiology Research laboratory, Riga Stradins University, 
      Riga, Latvia.
FAU - Guerra, Vito
AU  - Guerra V
AD  - National Institute of Gastroenterology 'S. de Bellis', Research Hospital, 
      Castellana Grotte, Italy.
FAU - Giovanella, Luca
AU  - Giovanella L
AD  - Clinic for Nuclear Medicine and Competence Center for Thyroid Diseases, Imaging 
      Institute of Southern Switzerland, Ente Ospedaliero Cantonale, Bellinzona, 
      Switzerland.
AD  - Clinic for Nuclear Medicine, University Hospital and University of Zurich, 
      Zurich, Switzerland.
FAU - Deandrea, Maurilio
AU  - Deandrea M
AUID- ORCID: 0000-0001-9217-8815
AD  - Endocrinology, Diabetes and Metabolic Disease Unit, Azienda Ospedaliera Ordine 
      Mauriziano, Torino, Italy.
FAU - Ngu, Rose
AU  - Ngu R
AD  - Head Neck and Thyroid Imaging, Department of Radiology, Guy's and St Thomas' 
      Hospitals NHS Foundation Trust, London, UK.
FAU - Durante, Cosimo
AU  - Durante C
AD  - Department of Translational and Precision Medicine, Sapienza University of Rome, 
      Rome, Italy.
FAU - Trimboli, Pierpaolo
AU  - Trimboli P
AD  - Clinic for Nuclear Medicine and Competence Center for Thyroid Diseases, Imaging 
      Institute of Southern Switzerland, Ente Ospedaliero Cantonale, Bellinzona, 
      Switzerland.
AD  - Faculty of Biomedical Sciences, Universita della Svizzera Italiana (USI), Lugano, 
      Switzerland.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PL  - England
TA  - Eur J Endocrinol
JT  - European journal of endocrinology
JID - 9423848
SB  - IM
MH  - Humans
MH  - Retrospective Studies
MH  - Risk Assessment/methods
MH  - Thyroid Nodule/diagnosis/*diagnostic imaging
MH  - Ultrasonography/methods
EDAT- 2020/06/17 06:00
MHDA- 2020/08/18 06:00
CRDT- 2020/06/17 06:00
PHST- 2020/03/08 00:00 [received]
PHST- 2020/06/16 00:00 [accepted]
PHST- 2020/06/17 06:00 [pubmed]
PHST- 2020/08/18 06:00 [medline]
PHST- 2020/06/17 06:00 [entrez]
AID - EJE-20-0204 [pii]
AID - 10.1530/EJE-20-0204 [doi]
PST - ppublish
SO  - Eur J Endocrinol. 2020 Sep;183(3):255-264. doi: 10.1530/EJE-20-0204.