{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T17:03:15Z","timestamp":1787936595634,"version":"build-2784847793"},"reference-count":18,"publisher":"MDPI AG","issue":"16","license":[{"start":{"date-parts":[[2025,8,21]],"date-time":"2025-08-21T00:00:00Z","timestamp":1755734400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Purpose: This study aimed to compare: the performance of K-TIRADS, EU-TIRADS and ACR TIRADS when used by observers with different levels of experience compared with the gold standard of cytology, and to evaluate the diagnostic performance of CAD (computer-aided design) compared with TI-RADS systems. Methods and Materials: In total, 323 thyroid nodules were evaluated in patients who were candidates for needle aspiration. Three observers with different levels of experience evaluated the diagnostic accuracy of three risk stratification systems (ACR TI-RADS, EU-TIRADS and K-TIRADS) and CAD software (S-Detect, made by Samsung) in characterizing the nodules. The results were compared with cytology examination. All nodules were characterized in terms of shape, margins, composition, calcifications, size, echogenicity and microcalcifications, and by stratifying individual nodules by using the three TIRADS systems; then S-detect software was applied and the data were compared with each other and with the gold standard. Results: Through cytology, 308 benign and 33 malignant nodules were identified. ACR-TIRADS showed a sensitivity of 100%, a specificity of 86%, a positive predictive value of 43% and a negative predictive value of 100%. EU-TIRADS showed a sensitivity of 100%, a specificity of 79%, a positive predictive value of 33% and a negative predictive value of 100%. K-TIRADS showed a sensitivity of 100%, a specificity of 89%, a positive predictive value of 50% and a negative predictive value of 100%. S-Detect combined with EU-TIRADS showed a high agreement (&gt;95%) with the gold standard. Conclusions: K-TIRADS\u2019s positive predictive power was slightly better than the other TIRADS, suggesting greater accuracy in correctly diagnosing positive cases. S-DETECT combined with EU-TIRADS has similar results to S-Detect with ACR- and K-TIRADS in terms of sensitivity, specificity and negative predictive power. However, it has a slightly better positive predictive power, suggesting greater accuracy in correctly diagnosing positive cases than the ACR- and K-TIRADS classification systems. In general, S-Detect cannot yet be considered a substitute for the human observer but only as an important support for human evaluation and an excellent and fast help to provide a comprehensive and complete report. Clinical Relevance\/Application: S-Detect is a valuable tool for characterizing thyroid nodules when integrated with radiologist evaluation. It is also an important support tool for less experienced observers. Particularly interesting is the approach of use in integrated combination of the K-TIRADS by the human observer with S-Detect using EU-TIRADS, which could increase the overall diagnostic efficiency of the systems.<\/jats:p>","DOI":"10.3390\/diagnostics15162108","type":"journal-article","created":{"date-parts":[[2025,8,21]],"date-time":"2025-08-21T14:46:04Z","timestamp":1755787564000},"page":"2108","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Thyroid Nodule Characterization: Which Thyroid Imaging Reporting and Data System (TIRADS) Is More Accurate? A Comparison Between Radiologists with Different Experiences and Artificial Intelligence Software"],"prefix":"10.3390","volume":"15","author":[{"given":"Emanuele","family":"David","sequence":"first","affiliation":[{"name":"Department of Medical Surgical Sciences and Advanced Technologies \u201cGF Ingrassia\u201d, University Hospital Policlinic \u201cG. Rodolico-San Marco\u201d, 95123 Catania, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9331-3441","authenticated-orcid":false,"given":"Lorenzo","family":"Aliotta","sequence":"additional","affiliation":[{"name":"Department of Medical Surgical Sciences and Advanced Technologies \u201cGF Ingrassia\u201d, University Hospital Policlinic \u201cG. Rodolico-San Marco\u201d, 95123 Catania, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9457-7617","authenticated-orcid":false,"given":"Fabrizio","family":"Frezza","sequence":"additional","affiliation":[{"name":"Department of Information Engineering, Electronics and Telecommunications, \u201cSapienza\u201d University of Rome, 00184 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-4699-4800","authenticated-orcid":false,"given":"Marianna","family":"Riccio","sequence":"additional","affiliation":[{"name":"Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8411-1805","authenticated-orcid":false,"given":"Alessandro","family":"Cannavale","sequence":"additional","affiliation":[{"name":"Department of Radiology, Anatomical-Patology and Oncology, Sapienza University of Rome, 00162 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrizia","family":"Pacini","sequence":"additional","affiliation":[{"name":"Department of Radiology, Anatomical-Patology and Oncology, Sapienza University of Rome, 00162 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara","family":"Di Bella","sequence":"additional","affiliation":[{"name":"Department of Radiology, Anatomical-Patology and Oncology, Sapienza University of Rome, 00162 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8397-8343","authenticated-orcid":false,"given":"Vincenzo","family":"Dolcetti","sequence":"additional","affiliation":[{"name":"Department of Radiology, Anatomical-Patology and Oncology, Sapienza University of Rome, 00162 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Seri","sequence":"additional","affiliation":[{"name":"Department of Radiology, Anatomical-Patology and Oncology, Sapienza University of Rome, 00162 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-2877-3169","authenticated-orcid":false,"given":"Luca","family":"Giuliani","sequence":"additional","affiliation":[{"name":"Department of Biotechnological and Applied Clinical Sciences, San Salvatore Hospital, University of L\u2019Aquila, Vetoio Stree, 67100 L\u2019Aquila, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4710-497X","authenticated-orcid":false,"given":"Mattia","family":"Di Segni","sequence":"additional","affiliation":[{"name":"Department of Radiology, Anatomical-Patology and Oncology, Sapienza University of Rome, 00162 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-0151-3317","authenticated-orcid":false,"given":"Gianmarco","family":"Lo Conte","sequence":"additional","affiliation":[{"name":"Department of Radiology, Anatomical-Patology and Oncology, Sapienza University of Rome, 00162 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giacomo","family":"Bonito","sequence":"additional","affiliation":[{"name":"Department of Radiology, Anatomical-Patology and Oncology, Sapienza University of Rome, 00162 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonino","family":"Guerrisi","sequence":"additional","affiliation":[{"name":"Radiology and Diagnostic Imaging Unit, Department of Clinical and Dermatological Research, San Gallicano Dermatological Institute IRCCS, Via Elio Chianesi 53, 00144 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5474-8952","authenticated-orcid":false,"given":"Fabio","family":"Mangini","sequence":"additional","affiliation":[{"name":"Department of Engineering, Niccol\u00f2 Cusano University, 00166 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco Maria","family":"Drudi","sequence":"additional","affiliation":[{"name":"Department of Radiology, Anatomical-Patology and Oncology, Sapienza University of Rome, 00162 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Corrado","family":"De Vito","sequence":"additional","affiliation":[{"name":"Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vito","family":"Cantisani","sequence":"additional","affiliation":[{"name":"Department of Radiology, Anatomical-Patology and Oncology, 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