Comparing Diagnostic Efficacy of C-TIRADS Positive Features on Different Sizes of Thyroid Nodules.

Purpose: To explore the diagnostic value of positive features in the Chinese Thyroid Imaging Reporting and Data System (C-TIRADS) for thyroid nodules of different sizes.

Patients And Methods: A total of 1864 patients with 2347 thyroid nodules were selected from January 2021 to December 2022 and assessed according to C-TIRADS. According to the maximum diameter, nodules were divided into the A1 group (≤10 mm), A2 group (>10 mm,<20 mm), and A3 group (≥20 mm). With surgical pathology as the golden standard, the receiver operating characteristic curves (ROC) were constructed, and each group's area under the curve (AUC) was calculated. The diagnostic value of positive features in C-TIRADS for different sizes of thyroid nodules was analyzed.

Results: In all groups, malignant thyroid nodules had a higher incidence of positive features than benign nodules (P < 0.05). In A1 group, the diagnostic efficiency of C-TIRADS positive features for thyroid nodules was vertical orientation> ill-defined/irregular margin or extrathyroidal extension> solid composition> markedly hypoechoic> microcalcifications. The AUCs were 0.718, 0.675, 0.609, 0.558, and 0.581, respectively. In A2 group, the diagnostic efficacy of each positive features for thyroid nodules was ill-defined/irregular margins or extra-thyroid invasion> solid composition> microcalcifications> markedly hypoechoic> vertical orientation. The AUCs were 0.854, 0.730, 0.719, 0.670, and 0.609, respectively. In A3 group, the diagnostic efficacy of each positive features for thyroid nodules was ill-defined/irregular margin or extrathyroidal extension> microcalcifications> solid composition> vertical orientation> markedly hypoechoic. The AUCs were 0.847, 0.778, 0.767, 0.584, and 0.560, respectively.

Conclusion: C-TIRADS positive features exhibited different diagnostic efficacy for thyroid nodules of various sizes, especially for thyroid nodules ≤10 mm, for which all positive features had low diagnostic efficacy.