{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T16:09:13Z","timestamp":1792080553699,"version":"4.4.0"},"reference-count":31,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,10,27]],"date-time":"2021-10-27T00:00:00Z","timestamp":1635292800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100013064","name":"Key Research and Development Program of Jiangxi Province","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100013064","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec><jats:title>Purpose<\/jats:title><jats:p>To explore the characteristics of C-TIRADS by comparing it with ACR-TIRADS, Kwak-TIRADS, KSThR-TIRADS and EU-TIRADS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 1096 nodules were collected from 884 patients undergoing thyroidectomy in our center between May 2018 and December 2020. Divided the nodules into two groups: \u201c&amp;gt;10mm\u201d and \u201c\u226410mm\u201d. Ultrasound characteristics of each nodule were observed and recorded by 2 doctors, then classified based on ACR-TIRADS, Kwak-TIRADS, KSThR-TIRADS, EU-TIRADS, and C-TIRADS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 682 benign nodules cases (62.23%) and 414 malignant nodules cases (37.77%) were identified. The ICC value of each guideline was:0.937(ACR-TIRADS), 0.858(EU-IRADS), 0.811(Kwak-TIRADS), 0.835(KTA\/KSThR-TIRADS) and 0.854(C-TIRADS). The nodule malignancy rates in the groups(Kwak-TIRADS 4B, C-TIRADS 4B\u30014C) of two sizes were significantly different (all p&amp;lt;0.05). There was no statistical difference in the other grades of two sizes (all p&amp;gt;0.05). Unnecessary biopsy rates were the lowest in C-TIRADS (49.02% p&amp;lt;0.001). Furthermore, Kwak-TIRADS had the highest sensitivity and NPV (89.9%, 91.0%, all p&amp;lt;0.05), while C-TIRADS had the highest specificity and PPV (82.3%, 69.2%, all p&amp;lt;0.05). C-TIRADS and Kwak-TIRADS had the highest accuracy (76.0%, 72.5%, P=0.071). The AUCs of the 5 guidelines were C-TIRADS(0.816, P&amp;lt;0.05), Kwak-TIRADS(0.789, P&amp;lt;0.05) KTA\/KSThR-TIRADS and ACR-TIRADS(0.773, 0.763, P=0.305), EU-TIRADS(0.734, P&amp;lt;0.05). The AUCs of the five guidelines were not statistically different between \u201cnodules&amp;gt;10mm\u201d and \u201cnodules \u2264 10mm\u201d (all P&amp;gt;0.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>All five guides showed excellent interobserver agreement. C-TIRADS was slightly efficient than Kwak-IRADS, KTA\/KSThR-TIRADS and ACR-TIRADS, and had greater advantages than EU-TIRADS. The diagnostic abilities of the five guidelines for \u201cnodules \u2264 10mm\u201d were not inferior to that of \u201cnodules&amp;gt; 10mm\u201d. C-TIRADS is simple and easy to implement and can provide effective thyroid tumor risk stratification for thyroid nodule diagnosis, especially in China.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fendo.2021.763897","type":"journal-article","created":{"date-parts":[[2021,10,27]],"date-time":"2021-10-27T06:22:26Z","timestamp":1635315746000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":41,"title":["Explore the Diagnostic Efficiency of Chinese Thyroid Imaging Reporting and Data Systems by Comparing With the Other Four Systems (ACR TI-RADS, Kwak-TIRADS, KSThR-TIRADS, and EU-TIRADS): A Single-Center Study"],"prefix":"10.3389","volume":"12","author":[{"given":"Qi","family":"Qi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aiyun","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suping","family":"Guo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xingzhi","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Songli","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yaohui","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pan","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2021,10,27]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"699","DOI":"10.1111\/j.1365-2362.2009.02162.x","article-title":"Very High Prevalence of Thyroid Nodules Detected by High Frequency (13 MHz) Ultrasound Examination","volume":"39","author":"Guth","year":"2009","journal-title":"Eur J Clin Invest"},{"key":"B2","doi-asserted-by":"publisher","first-page":"893","DOI":"10.1148\/radiol.2018171074","article-title":"US Fine-Needle Aspiration Biopsy for Thyroid Malignancy: Diagnostic Performance of Seven Society Guidelines Applied to 2000 Thyroid Nodules","volume":"287","author":"Ha","year":"2018","journal-title":"Radiology"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2016160641","article-title":"Diagnosis and Management of Small Thyroid Nodules: A Comparative Study With Six Guidelines for Thyroid Nodules","volume":"283","author":"Yoon","year":"2017","journal-title":"Radiology"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2015150056","article-title":"Malignancy Risk Stratification of Thyroid Nodules: Comparison Between the Thyroid Imaging Reporting and Data System and the 2014 American Thyroid Association Management Guidelines","volume":"278","author":"Yoon","year":"2016","journal-title":"Radiology"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2017.0363","article-title":"Validation of Three Scoring Risk-Stratification Models for Thyroid Nodules","volume":"27","author":"Ha","year":"2017","journal-title":"Thyroid"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.18.20510","article-title":"Similarities and Differences Between Thyroid Imaging Reporting and Data Systems","volume":"213","author":"Yoon","year":"2019","journal-title":"AJR Am J Roentgenol"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-020-06722-y","article-title":"Pattern-Based vs. Score-Based Guidelines Using Ultrasound Features Have Different Strengths in Risk Stratification of Thyroid Nodules","volume":"30","author":"Yoon","year":"2020","journal-title":"Eur Radiol"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.4158\/EP-2019-0237","article-title":"Comparison Of Diagnostic Performance Between The American College of Radiology Thyroid Imaging Reporting And Data System And American Thyroid Association Guidelines: A Systematic Review","volume":"26","author":"Hang","year":"2020","journal-title":"Endocr Pract"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.11110206","article-title":"Thyroid Imaging Reporting and Data System for US Features of Nodules: A Step in Establishing Better Stratification of Cancer Risk","volume":"260","author":"Kwak","year":"2011","journal-title":"Radiology"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.3348\/kjr.2016.17.3.370","article-title":"Ultrasonography Diagnosis and Imaging-Based Management of Thyroid Nodules: Revised Korean Society of Thyroid Radiology Consensus Statement and Recommendations","volume":"17","author":"Shin","year":"2016","journal-title":"Korean J Radiol"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacr.2017.01.046","article-title":"ACR Thyroid Imaging, Reporting and Data System (TI-RADS): White Paper of the ACR TI-RADS Committee","volume":"14","author":"Tessler","year":"2017","journal-title":"J Am Coll Radiol"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1159\/000478927","article-title":"European Thyroid Association Guidelines for Ultrasound Malignancy Risk Stratification of Thyroid Nodules in Adults: The EU-TIRADS","volume":"6","author":"Russ","year":"2017","journal-title":"Eur Thyroid J"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1007\/s12020-020-02441-y","article-title":"2020 Chinese Guidelines for Ultrasound Malignancy Risk Stratification of Thyroid Nodules: The C-TIRADS","volume":"70","author":"Zhou","year":"2020","journal-title":"Endocrine"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1007\/s12020-019-01843-x","article-title":"Comparison Among TIRADS (ACR TI-RADS and KWAK- TI-RADS) and 2015 ATA Guidelines in the Diagnostic Efficiency of Thyroid Nodules","volume":"64","author":"Gao","year":"2019","journal-title":"Endocrine"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.3348\/kjr.2018.19.4.623","article-title":"Primary Imaging Test and Appropriate Biopsy Methods for Thyroid Nodules: Guidelines by Korean Society of Radiology and National Evidence-Based Healthcare Collaborating Agency","volume":"19","author":"Ha","year":"2018","journal-title":"Korean J Radiol"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1038\/srep43183","article-title":"Thyroid Nodule Sizes Influence the Diagnostic Performance of TIRADS and Ultrasound Patterns of 2015 ATA Guidelines: A Multicenter Retrospective Study","volume":"7","author":"Xu","year":"2017","journal-title":"Sci Rep"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1002\/jcu.20689","article-title":"Observer Variability in the Sonographic Evaluation of Thyroid Nodules","volume":"38","author":"Park","year":"2010","journal-title":"J Clin Ultrasound"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2019.0360","article-title":"Frasoldati A Et Al: Inter- and Intraobserver Agreement in the Assessment of Thyroid Nodule Ultrasound Features and Classification Systems: A Blinded Multicenter Study","volume":"30","author":"Persichetti","year":"2020","journal-title":"Thyroid"},{"key":"B19","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1530\/EC-17-0336","article-title":"Durante C: Interobserver Agreement of Various Thyroid Imaging Reporting and Data Systems","volume":"7","author":"Grani","year":"2018","journal-title":"Endocr Connect"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejrad.2020.109390","article-title":"Comparison of Diagnostic Accuracy of ACR-TIRADS, American Thyroid Association (ATA), and EU-TIRADS Guidelines in Detecting Thyroid Malignancy","volume":"133","author":"Koc","year":"2020","journal-title":"Eur J Radiol"},{"key":"B21","doi-asserted-by":"publisher","first-page":"236","DOI":"10.3390\/jcm9010236","article-title":"Diagnostic Performance of Different Thyroid Imaging Reporting and Data Systems (Kwak-TIRADS, EU-TIRADS and ACR TI-RADS) for Risk Stratification of Small Thyroid Nodules (<\/=10 Mm)","volume":"9","author":"Schenke","year":"2020","journal-title":"J Clin Med"},{"key":"B22","doi-asserted-by":"publisher","first-page":"33","DOI":"10.1016\/j.ejrad.2018.10.024","article-title":"Combination of Ultrasound Elastography With TI-RADS in the Diagnosis of Small Thyroid Nodules (<\/=10 Mm): A New Method to Increase the Diagnostic Performance","volume":"109","author":"Du","year":"2018","journal-title":"Eur J Radiol"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2018.0094","article-title":"Diagnostic Performance of Ultrasound-Based Risk-Stratification Systems for Thyroid Nodules: Comparison of the 2015 American Thyroid Association Guidelines With the 2016 Korean Thyroid Association\/Korean Society of Thyroid Radiology and 2017 American College of Radiology Guidelines","volume":"28","author":"Ha","year":"2018","journal-title":"Thyroid"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.1007\/s12020-019-01886-0","article-title":"Comparison and Preliminary Discussion of the Reasons for the Differences in Diagnostic Performance and Unnecessary FNA Biopsies Between the ACR TIRADS and 2015 ATA Guidelines","volume":"65","author":"Wu","year":"2019","journal-title":"Endocrine"},{"key":"B25","doi-asserted-by":"publisher","first-page":"492","DOI":"10.1530\/EC-21-0034","article-title":"Assessment of Perinodular Stiffness in Differentiating Malignant From Benign Thyroid Nodules","volume":"10","author":"Hu","year":"2021","journal-title":"Endocr Connect"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.21037\/qims-20-1365","article-title":"Diagnostic Performance of US-Based FNAB Criteria of the 2020 Chinese Guideline for Malignant Thyroid Nodules: Comparison With the 2017 American College of Radiology Guideline, the 2015 American Thyroid Association Guideline, and the 2016 Korean Thyroid Association Guideline","volume":"11","author":"Zhu","year":"2021","journal-title":"Quant Imaging Med Surg"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.1259\/bjr.20170642","article-title":"Fine Needle Aspiration Biopsy of Thyroid Nodule Smaller Than 1.0 Cm: Accuracy of TIRADS Classification System in More Than 1000 Nodules","volume":"91","author":"Mendes","year":"2018","journal-title":"Br J Radiol"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2017.0034","article-title":"Detection of Malignancy Among Suspicious Thyroid Nodules <1 Cm on Ultrasound With Various Thyroid Image Reporting and Data Systems","volume":"27","author":"Ha","year":"2017","journal-title":"Thyroid"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.1097\/RLU.0b013e318279bc65","article-title":"Aggressive Papillary Thyroid Microcarcinoma: Prognostic Factors and Therapeutic Strategy","volume":"38","author":"Ardito","year":"2013","journal-title":"Clin Nucl Med"},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-007-9453-0","article-title":"Papillary Microcarcinoma","volume":"32","author":"Noguchi","year":"2008","journal-title":"World J Surg"},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.1007\/s12020-015-0526-9","article-title":"Thyroid Nodules <\/= 5 Mm on Ultrasonography: Are They \"Leave Me Alone\" Lesions","volume":"49","author":"Moon","year":"2015","journal-title":"Endocrine"}],"container-title":["Frontiers in Endocrinology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2021.763897\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,10,27]],"date-time":"2021-10-27T06:22:29Z","timestamp":1635315749000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2021.763897\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,10,27]]},"references-count":31,"alternative-id":["10.3389\/fendo.2021.763897"],"URL":"https:\/\/doi.org\/10.3389\/fendo.2021.763897","relation":{},"ISSN":["1664-2392"],"issn-type":[{"value":"1664-2392","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,10,27]]},"article-number":"763897"}}