Population study on thyroid nodule ultrasound (TUS) reports quality with adherence to guidelines

Hu Xun Yang; Jiahui Wu; Paula Seal; Sana Ghaznavi; Christopher Symonds; Susan Kinnear; Ralf Paschke

doi:10.1530/endoabs.84.OP-12-60

OP-12-60

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Endocrine Abstracts (2022) 84 OP12-60 | DOI: 10.1530/endoabs.84.OP-12-60

ETA2022 Oral Presentations Oral Session 12: Nodules and Diagnostic (5 abstracts)

Population study on thyroid nodule ultrasound (TUS) reports quality with adherence to guidelines

Xun Yang Hu ¹ , Jiahui Wu ² , Paula Seal ³ , Sana Ghaznavi ¹ , Christopher Symonds ¹ , Susan Kinnear ¹ & Ralf Paschke ⁴

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¹University of Calgary, Department of Medicine, Section of Endocrinology, Calgary, Canada; ²University of Calgary, Arnie Charbonneau Cancer Institute, Cumming School of Medicine, Calgary, Canada; ³Efw Radiology, Calgary, Canada; ⁴Dept. of Medicine, Cumming School of Medicine,, University of Calgary, Calgary, Canada

Objectives: To date, there has been no population-wide data looking at the adherence to published TUS reporting guidelines for thyroid nodule malignancy risk assessment. In our health care region in 2018, two radiology groups worked closely with endocrinologists to improve the quality of their TUS reports by adhering to the 2015 ATA or the 2017 TIRADS guidelines. We aim to present the improvement in TUS reports quality with these dedicated changes.

Methods: We analyzed the TUS reports of 981 patients from two prospective databases covering a population of 1.5 million people. We measured the reports’ utility score (UtS; range 0–6), which is calculated based on the number of nodule characteristics provided in the report, and rate of ATA or TIRADS classification given by TUS, to assess the TUS report quality. The TUS report quality of the two radiology groups and other radiology groups were compared to each other. Since the two radiology groups implemented their adherence to guidelines in 2018, we then divided the databases into pre-2018 TUS reports and 2018-onwards reports and compared each group’s later reports to its earlier ones.

Results: The two groups that implemented strict adherence to ATA or TIRADS guidelines had significantly higher UtS compared to other groups among the 2018-onwards reports. There was also a significant improvement in the UtS of the guideline-adhering radiology groups when comparing their TUS reports from pre-2018 vs those from 2018-onwards (Table 1). Additionally, the two groups also had higher rates of including an ATA or TIRADS classification in their report. and overall, they had a substantially higher likelihood of providing TUS reports with both a clinically useful UtS of 4 or greater and an ATA or TIRADS classification. This allows for clinicians to better estimate the risk of malignancy of thyroid nodules.

Table 1. Mean UtS and percentage of reports with an ATA or TIRADS classification for pre-2018 TUS reports vs 2018-onwards TUS reports.
pre-2018	Mean UtS	Classification reporting rate	Number of reports
Radiology group 1	3.62	39.4%	71
Radiology group 2	2.8	11.5%	87
Other radiology groups	2.49	32.2%	171
2018-onwards	Mean UtS	Classification reporting rate	Number of reports
Radiology group 1	5.77	97.0%	133
Radiology group 2	5.58	93.3%	178
Other radiology groups	3.28	61.8%	259

Conclusions: Our data indicates that with dedicated adherence to the ATA or TIRADS guidelines, radiology groups can significantly improve the quality and utility of their TUS reports to better help clinicians manage thyroid nodules in a risk stratified manner, and to also help avoid unnecessary anxiety and additional testing and surgery.