Performance of ACR-TIRADS in assessing thyroid nodules does not vary according to patient age

Hormones (Athens). 2024 Dec;23(4):667-674. doi: 10.1007/s42000-024-00585-4. Epub 2024 Jul 19.

Abstract

Aims: A few studies have evaluated the performance of the American College of Radiology Thyroid Imaging Reporting And Data System (ACR-TIRADS) in pediatric and elderly patients and found differences between the latter two age groups and middle adulthood. Thus, the present study was undertaken to explore the possible variation of ACR-TIRADS performance across different ages of patients.

Methods: A retrospective population undergoing thyroidectomy was selected to use histology as the reference standard. Ultrasound images were reviewed, and alignment of ACR-TIRADS with the corresponding histological diagnosis was made afterwards. Results of the age groups were compared. The ACR-TIRADS diagnostic performance was calculated considering the assessment of nodules across risk categories (i.e., from TR1 to TR5), rate of unnecessary FNAC (UN-FNAC), and rate of necessary but non-performed FNAC (NNP-FNAC).

Results: Overall, 114 patients with a total of 220 nodules (46 carcinomas) were included. The rate of UN-FNAC was 66.3%, being 93.1% in TR3, 82.1% in TR4, and 31.4% in TR5. There were 15 NNP-FNACs. No significant difference was observed between age groups in terms of sample size, nodule, cancer, and FNAC. The nodule assessment according to ACR-TIRADS categories did not vary across ages. Sensitivity and specificity recorded in three age tertiles were not significantly different.

Conclusions: The present study shows that the performance of ACR-TIRADS is not significantly influenced by patient age.

Keywords: Age; Elderly; FNAC; TIRADS; Thyroid; Young.

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Biopsy, Fine-Needle
  • Female
  • Humans
  • Male
  • Middle Aged
  • Retrospective Studies
  • Thyroid Gland / diagnostic imaging
  • Thyroid Gland / pathology
  • Thyroid Neoplasms / diagnostic imaging
  • Thyroid Neoplasms / pathology
  • Thyroid Nodule* / diagnostic imaging
  • Thyroid Nodule* / pathology
  • Thyroidectomy
  • Ultrasonography* / standards
  • Young Adult