{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T16:21:57Z","timestamp":1759940517964,"version":"3.37.3"},"reference-count":22,"publisher":"Georg Thieme Verlag KG","issue":"02","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Exp Clin Endocrinol Diabetes"],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Several ultrasound-based risk stratification systems (RSSs) have been\n                        developed and introduced into clinical practice for managing thyroid\n                        nodules. However, there are essential differences among these systems. This\n                        study aimed to determine and compare the category-based diagnostic\n                        performance of four ultrasound-based risk stratification systems in the\n                        detection of thyroid cancer: ACR-TIRADS, ATA, K-TIRADS, and EU-TIRADS.<\/jats:p><jats:p>This study included 4238 nodules sampled by fine-needle aspiration biopsy\n                        between January 2018 and December 2021. Nodules were classified according to\n                        ultrasound imaging features and correlated with biopsy results. The\n                        diagnostic success of the risk stratification systems was evaluated and\n                        compared.<\/jats:p><jats:p>Of the 4238 nodules, 3861 (91.1%) were benign and 376 (8.9%) were malignant.\n                        Malignancy was significantly higher in hypoechoic and marked hypoechoic\n                        nodules (p=0.001), and solid nodules (p=0.002). For detection of malignancy,\n                        areas under the receiving operator characteristics curves were 0.862, 0.850,\n                        0.842, and 0.835 for 2017 ACR-TIRADS, EU-TIRADS, for K-TIRADS, and 2015\n                        American Thyroid Association guidelines, respectively. EU-TIRADS showed the\n                        highest sensitivity (91%), whereas ACR-TIRADS had the highest specificity\n                        (87%). Compared to other risk stratification systems, ACR-TIRADS resulted in\n                        significantly fewer unnecessary biopsies (p=0.009). <\/jats:p><jats:p>All RSSs show high diagnostic accuracy and have their own advantages and\n                        disadvantages. When selecting an appropriate RSS, the population, the\n                        prevalence of the disease, and gender distribution should be considered.<\/jats:p>","DOI":"10.1055\/a-2498-7952","type":"journal-article","created":{"date-parts":[[2024,12,10]],"date-time":"2024-12-10T00:17:17Z","timestamp":1733789837000},"page":"98-104","source":"Crossref","is-referenced-by-count":2,"title":["Comparison of Diagnostic Performances of ATA Guidelines, ACR-TIRADS,\n                    and EU-TIRADS and Modified K-TIRADS: A Single Center Study of 4238 Thyroid\n                    Nodules"],"prefix":"10.1055","volume":"133","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1934-5346","authenticated-orcid":false,"given":"Mustafa","family":"\u00d6zdemir","sequence":"additional","affiliation":[{"name":"Department of Radiology, Sakarya University Faculty of\n                    Medicine, Sakarya, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5374-9731","authenticated-orcid":false,"given":"Gamze","family":"T\u00fcrk","sequence":"additional","affiliation":[{"name":"Department of Radiology, Kayseri City Hospital,\n                    Kayseri, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4213-5689","authenticated-orcid":false,"given":"Mustafa","family":"Bilgili","sequence":"additional","affiliation":[{"name":"Department of Radiology, Kayseri City Hospital,\n                    Kayseri, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1190-1800","authenticated-orcid":false,"given":"Ebru","family":"Akay","sequence":"additional","affiliation":[{"name":"Department of Pathology, Kayseri City Hospital,\n                    Kayseri, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0296-4914","authenticated-orcid":false,"given":"Ali","family":"Ko\u00e7","sequence":"additional","affiliation":[{"name":"Department of Radiology, Kayseri City Hospital,\n                    Kayseri, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2025,1,29]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"622","DOI":"10.4158\/ep161208.gl","article-title":"American Association of Clinical Endocrinologists, American College of\n                    Endocrinology, and Associazione Medici Andocrinologi medical guidelines for\n                    clinical practice for the diagnosis and management of thyroid nodules \u2013 2016\n                    update","volume":"22","author":"H Gharib","year":"2016","journal-title":"Endocr pract"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"147","DOI":"10.1159\/000354537","article-title":"2013 European thyroid association guidelines for cervical ultrasound scan and\n                    ultrasound-guided techniques in the postoperative management of patients with\n                    thyroid cancer","volume":"2","author":"L Leenhardt","year":"2013","journal-title":"Eur Thyroid J"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"1127","DOI":"10.1089\/thy.2015.0116","article-title":"The impact of diagnostic changes on the rise in thyroid cancer incidence: A\n                    population-based study in selected high-resource countries","volume":"25","author":"S Vaccarella","year":"2015","journal-title":"Thyroid"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1089\/thy.2015.0020","article-title":"2015 American Thyroid Association management guidelines for adult patients with\n                    thyroid nodules and differentiated thyroid cancer: The American Thyroid\n                    Association Guidelines task force on thyroid nodules and differentiated thyroid\n                    cancer","volume":"26","author":"B R Haugen","year":"2016","journal-title":"Thyroid"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"225","DOI":"10.1159\/000478927","article-title":"European Thyroid Association Guidelines for ultrasound malignancy risk\n                    stratification of thyroid nodules in adults: The EU-TIRADS","volume":"6","author":"G Russ","year":"2017","journal-title":"Eur Thyroid J"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"2094","DOI":"10.3348\/kjr.2021.0713","article-title":"2021 Korean thyroid imaging reporting and data system and imaging-based\n                    management of thyroid nodules: Korean Society of Thyroid Radiology consensus\n                    statement and recommendations","volume":"22","author":"E J Ha","year":"2021","journal-title":"Korean 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Cytopathol"},{"key":"ref10","first-page":"9","article-title":"Epidemiology of thyroid cancer. In: Wartofsky L, Van Nostrand D, Eds","author":"J J Figge","year":"2016","journal-title":"New York: Springer"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"3793","DOI":"10.1007\/s00330-020-06722-y","article-title":"Pattern-based vs. score-based guidelines using ultrasound features have\n                    different strengths in risk stratification of thyroid nodules","volume":"30","author":"J H Yoon","year":"2020","journal-title":"Eur Radiol"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"90","DOI":"10.1007\/s12020-019-01843-x","article-title":"Comparison among TIRADS (ACR TI-RADS and KWAK- TI-RADS) and 2015 ATA Guidelines\n                    in the diagnostic efficiency of thyroid nodules","volume":"64","author":"L Gao","year":"2019","journal-title":"Endocrine"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"1532","DOI":"10.1089\/thy.2018.0094","article-title":"Diagnostic performance of ultrasound-based risk-stratification systems for\n                    thyroid nodules: Comparison of the 2015 American Thyroid Association Guidelines\n                    with the 2016 Korean Thyroid Association\/Korean Society of Thyroid Radiology and\n                    2017 American College of Radiology Guidelines","volume":"28","author":"E J Ha","year":"2018","journal-title":"Thyroid"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"424","DOI":"10.3390\/cancers15020424","article-title":"Diagnostic performance of various ultrasound risk stratification systems for\n                    benign and malignant thyroid nodules: A meta-analysis","volume":"15","author":"J S Kim","year":"2023","journal-title":"Cancers (Basel)"},{"key":"ref15","doi-asserted-by":"crossref","first-page":"e230242","DOI":"10.1530\/ETJ-23-0242","article-title":"Head-to-head comparison of American, European, and Asian TIRADSs in thyroid\n                    nodule assessment: Systematic review and meta-analysis","volume":"13","author":"T Piticchio","year":"2024","journal-title":"Eur Thyroid J"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"1793","DOI":"10.1002\/cncr.29289","article-title":"Increasing diagnosis of subclinical thyroid cancers leads to spurious\n                    improvements in survival rates","volume":"121","author":"A S Ho","year":"2015","journal-title":"Cancer"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"111","DOI":"10.1007\/s00268-010-0832-6","article-title":"Therapeutic strategy for differentiated thyroid carcinoma in Japan based on a\n                    newly established guideline managed by Japanese Society of Thyroid Surgeons and\n                    Japanese Association of Endocrine Surgeons","volume":"35","author":"H Takami","year":"2011","journal-title":"World J Surg"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"488","DOI":"10.1089\/thy.2017.0448","article-title":"Trends in the implementation of active surveillance for low-risk papillary\n                    thyroid microcarcinomas at Kuma Hospital: Gradual increase and heterogeneity in\n                    the acceptance of this new management option","volume":"28","author":"Y Ito","year":"2018","journal-title":"Thyroid"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"46","DOI":"10.1016\/j.surg.2019.03.040","article-title":"Active surveillance of low-risk papillary thyroid cancer: A meta-analysis","volume":"167","author":"B Saravana-Bawan","year":"2020","journal-title":"Surgery"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"1535","DOI":"10.1089\/thy.2016.0075","article-title":"Thyroid cancer screening in South Korea increases detection of papillary cancers\n                    with no impact on other subtypes or thyroid cancer mortality","volume":"26","author":"H S Ahn","year":"2016","journal-title":"Thyroid"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"1159","DOI":"10.1089\/thy.2019.0812","article-title":"Diagnostic performance of four ultrasound risk stratification systems: A\n                    systematic review and meta-analysis","volume":"30","author":"P H Kim","year":"2020","journal-title":"Thyroid"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"121","DOI":"10.1007\/s12020-019-01886-0","article-title":"Comparison and preliminary discussion of the reasons for the differences in\n                    diagnostic performance and unnecessary FNA biopsies between the ACR TIRADS and\n                    2015 ATA guidelines","volume":"65","author":"X L Wu","year":"2019","journal-title":"Endocrine"}],"container-title":["Experimental and Clinical Endocrinology &amp; Diabetes"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2498-7952.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,8]],"date-time":"2025-02-08T01:25:58Z","timestamp":1738977958000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2498-7952"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12,9]]},"references-count":22,"journal-issue":{"issue":"02","published-online":{"date-parts":[[2025,2,7]]},"published-print":{"date-parts":[[2025,2]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2498-7952","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0947-7349","1439-3646"],"issn-type":[{"type":"print","value":"0947-7349"},{"type":"electronic","value":"1439-3646"}],"subject":[],"published-other":{"date-parts":[[2024,12,9]]},"published":{"date-parts":[[2024,12,9]]}}}