Introduction: A number of classification systems (TIRADS) have been developed to estimate the likelihood of malignancy in thyroid nodules, but their reproducibility is yet to be assessed. We evaluated the interobserver variability and diagnostic performance of the TIRADS in Kwak’s modification (Kw-TIRADS) and European TIRADS (EU-TIRADS). Methods: Two independent specialists, blinded concerning the morphology of the nodules, evaluated ultrasound images of 153 thyroid nodules identified in 149 patients at multiple time points. Results: The interobserver agreement (Cohen’s κ) was 0.52 and 0.67 for Kw-TIRADS and EU-TIRADS, respectively, and rated as substantial. There were strong correlations between Kw-TIRADS and EU-TIRADS for the two observers with Spearman’s coefficients of 0.731 (p = 0.00025) and 0.661 (p = 0.0012), respectively. Sensitivity of Kw-TIRADS for the diagnosis of thyroid cancer was 95–92.31% and that of EU-TIRADS was 92.31–89.74%, with specificity of about 60% for both TIRADS. Conclusion: Despite the wide variability in the description of single ultrasonographic features, both Kw-TIRADS and EU-TIRADS may be a useful diagnostic tool in clinical practice.
Eur Thyroid J

中文翻译：

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不同甲状腺成像和报告数据系统 (TIRADS) 的再现性和观察者间一致性

介绍：已经开发了许多分类系统 (TIRADS) 来估计甲状腺结节恶性的可能性，但它们的可重复性还有待评估。我们评估了 TIRADS 在 Kwak 修改 (Kw-TIRADS) 和欧洲 TIRADS (EU-TIRADS) 中的观察者间变异性和诊断性能。方法：两名对结节形态不知情的独立专家评估了 149 名患者在多个时间点确定的 153 个甲状腺结节的超声图像。结果：Kw-TIRADS 和 EU-TIRADS 的观察者间一致性（Cohen's κ）分别为 0.52 和 0.67，被评为实质性。两个观察者的 Kw-TIRADS 和 EU-TIRADS 之间存在很强的相关性，Spearman 的系数分别为 0.731 ( p = 0.00025) 和 0.661 ( p = 0.0012)。Kw-TIRADS 诊断甲状腺癌的敏感性为 95-92.31%，EU-TIRADS 的敏感性为 92.31-89.74%，两种 TIRADS 的特异性均约为 60%。结论：尽管单个超声特征的描述存在很大差异，但 Kw-TIRADS 和 EU-TIRADS 可能是临床实践中有用的诊断工具。
欧洲甲状腺杂志