{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T02:41:04Z","timestamp":1792982464109,"version":"4.5.0"},"reference-count":36,"publisher":"The Endocrine Society","issue":"1","funder":[{"DOI":"10.13039\/501100004271","name":"Sapienza UniversitA di Roma","doi-asserted-by":"publisher","award":["AR216154C9B479B2"],"award-info":[{"award-number":["AR216154C9B479B2"]}],"id":[{"id":"10.13039\/501100004271","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,1,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Context<\/jats:title>\n                    <jats:p>The prevalence of thyroid nodules in the general population is increasingly high, and at least half of those biopsied prove to be benign. Sonographic risk-stratification systems are being proposed as \u201crule-out\u201d tests that can identify nodules that do not require fine-needle aspiration (FNA) cytology.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To comparatively assess the performances of five internationally endorsed sonographic classification systems [those of the American Thyroid Association, the American Association of Clinical Endocrinologists, the American College of Radiology (ACR), the European Thyroid Association, and the Korean Society of Thyroid Radiology] in identifying nodules whose FNAs can be safely deferred and to estimate their negative predictive values (NPVs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Prospective study of thyroid nodules referred for FNA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Single academic referral center.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients<\/jats:title>\n                    <jats:p>Four hundred seventy-seven patients (358 females, 75.2%); mean (SD) age, 55.9 (13.9) years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcome Measures<\/jats:title>\n                    <jats:p>Number of biopsies classified as unnecessary, false-negative rate (FNR), sensitivity, specificity, predictive values, and diagnostic ORs for each system.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Application of the systems\u2019 FNA criteria would have reduced the number of biopsies performed by 17.1% to 53.4%. The ACR Thyroid Imaging Reporting and Data System (TIRADS) allowed the largest reduction (268 of 502) with the lowest FNR (NPV, 97.8%; 95% CI, 95.2% to 99.2%). Except for the Korean Society of Thyroid Radiology TIRADS, all other systems exhibited significant discriminatory performance but produced significantly smaller reductions in the number of procedures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Internationally endorsed sonographic risk stratification systems vary widely in their ability to reduce the number of unnecessary thyroid nodule FNAs. The ACR TIRADS outperformed the others, classifying more than half the biopsies as unnecessary with a FNR of 2.2%.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1210\/jc.2018-01674","type":"journal-article","created":{"date-parts":[[2018,10,8]],"date-time":"2018-10-08T14:37:03Z","timestamp":1539009423000},"page":"95-102","source":"Crossref","is-referenced-by-count":273,"title":["Reducing the Number of Unnecessary Thyroid Biopsies While Improving Diagnostic Accuracy: Toward the \u201cRight\u201d TIRADS"],"prefix":"10.1210","volume":"104","author":[{"given":"Giorgio","family":"Grani","sequence":"first","affiliation":[{"name":"Dipartimento di Medicina Interna e Specialit\u00e0 Mediche, Universit\u00e0 di Roma \u201cSapienza,\u201d Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Livia","family":"Lamartina","sequence":"additional","affiliation":[{"name":"Dipartimento di Medicina Interna e Specialit\u00e0 Mediche, Universit\u00e0 di Roma 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Universit\u00e0 di Roma \u201cSapienza,\u201d Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marianna","family":"Maranghi","sequence":"additional","affiliation":[{"name":"Dipartimento di Medicina Interna e Specialit\u00e0 Mediche, Universit\u00e0 di Roma \u201cSapienza,\u201d Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosa","family":"Falcone","sequence":"additional","affiliation":[{"name":"Dipartimento di Medicina Interna e Specialit\u00e0 Mediche, Universit\u00e0 di Roma \u201cSapienza,\u201d Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valeria","family":"Ramundo","sequence":"additional","affiliation":[{"name":"Dipartimento di Medicina Interna e Specialit\u00e0 Mediche, Universit\u00e0 di Roma \u201cSapienza,\u201d Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vito","family":"Cantisani","sequence":"additional","affiliation":[{"name":"UOS Innovazioni Diagnostiche e Ultrasonografiche, Azienda Ospedaliera Universitaria Policlinico Umberto I, Universit\u00e0 di Roma \u201cSapienza,\u201d Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastiano","family":"Filetti","sequence":"additional","affiliation":[{"name":"Dipartimento di Medicina Interna e Specialit\u00e0 Mediche, Universit\u00e0 di Roma \u201cSapienza,\u201d Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1791-5915","authenticated-orcid":false,"given":"Cosimo","family":"Durante","sequence":"additional","affiliation":[{"name":"Dipartimento di Medicina Interna e Specialit\u00e0 Mediche, Universit\u00e0 di Roma \u201cSapienza,\u201d Rome, 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