The purpose of this study was to assess inter-observer variability and performance when sonographers assign features to thyroid nodules on ultrasound using the American College of Radiology (ACR) Thyroid Imaging Reporting and Data System (TI-RADS). Fifteen sonographers retrospectively evaluated 100 thyroid nodules and assigned features to each nodule according to ACR TI-RADS lexicon. Ratings were compared with one another and to a gold standard using Fleiss’ and Cohen's kappa statistics, respectively. Sonographers were also asked subjective questions regarding their comfort level assessing each feature, and opinions were compared with performance using a mixed effects model. Sonographers demonstrated only slight agreement for margin (κ = 0.18, 95% confidence interval [CI]: 0.16–0.20) and large comet tail artifact (κ = 0.08, 95% CI: 0.06–0.10) but better performance for macrocalcification (κ = 0.41, 95% CI: 0.39–0.43) and no echogenic foci (κ = 0.52, 95% CI: 0.50–0.54). Sonographer comfort level with different feature assignments did not statistically correlate with performance for a given feature. In conclusion, sonographers using ACR TI-RADS to assign thyroid nodule features on ultrasound demonstrate a range of agreement across features, with margin and large comet tail artifact showing the most variability. These results highlight potential areas of focus for sonographer education efforts as ACR TI-RADS continues to be implemented in radiology departments.

本研究的目的是评估当超声医师使用美国放射学会 (ACR) 甲状腺成像报告和数据系统 (TI-RADS) 为超声检查甲状腺结节分配特征时，观察者间的变异性和表现。15 名超声技师回顾性评估了 100 个甲状腺结节，并根据 ACR TI-RADS 词典为每个结节分配了特征。分别使用 Fleiss 和 Cohen 的 kappa 统计数据将评级相互比较并与黄金标准进行比较。还向超声检查员询问了有关评估每个功能的舒适度的主观问题，并使用混合效应模型将意见与性能进行了比较。超声检查人员仅证明了边缘（κ = 0.18，95% 置信区间 [CI]：0.16-0.20）和大彗尾伪影（κ = 0.08，95% CI：0.06-0。10) 但在宏观钙化（κ = 0.41, 95% CI: 0.39–0.43）和无回声病灶（κ = 0.52, 95% CI: 0.50–0.54）方面表现更好。具有不同功能分配的超声检查员舒适度与给定功能的性能没有统计相关性。总之，超声医师使用 ACR TI-RADS 分配超声上的甲状腺结节特征表现出一系列特征之间的一致性，边缘和大彗尾伪影显示出最大的可变性。随着 ACR TI-RADS 继续在放射科实施，这些结果突出了超声医师教育工作的潜在重点领域。具有不同功能分配的超声检查员舒适度与给定功能的性能没有统计相关性。总之，超声医师使用 ACR TI-RADS 分配超声上的甲状腺结节特征表现出一系列特征之间的一致性，边缘和大彗尾伪影显示出最大的可变性。随着 ACR TI-RADS 继续在放射科实施，这些结果突出了超声医师教育工作的潜在重点领域。具有不同功能分配的超声检查员舒适度与给定功能的性能没有统计相关性。总之，超声医师使用 ACR TI-RADS 分配超声上的甲状腺结节特征表现出一系列特征之间的一致性，边缘和大彗尾伪影显示出最大的可变性。随着 ACR TI-RADS 继续在放射科实施，这些结果突出了超声医师教育工作的潜在重点领域。