Endocrine Abstracts

Objective: This study aims to assess and suggest improvements to the Thyroid Imaging Reporting and Data System (TI-RADS), incorporating both classical ultrasound (US) features and contrast-enhanced ultrasound (CEUS) patterns, to refine malignancy risk categorization in thyroid nodules.

Methods: In this study, 250 solid thyroid nodules, all subsequently confirmed by thyroidectomy and pathology, were evaluated using European TI-RADS guidelines and qualitative CEUS. This approach aimed at achieving more accurate risk stratification crucial for effective clinical management.

Results: Out of the examined nodules, 71 were malignant. The conventional TI-RADS showed a diagnostic performance with an area under the curve (AUC) of 0.720, sensitivity of 84.3%, and specificity of 45.2%. In contrast, CEUS demonstrated superior diagnostic efficacy, particularly when identifying benign nodules through homogeneous enhancement and peripheral rings (AUC=0.800 and 0.830). Markers such as inhomogeneous enhancement and unenhanced areas were strong indicators of malignancy (AUC=0.850 and 0.740). The combined use of TI-RADS and CEUS (TI-RADS + CEUS model) significantly enhanced diagnostic accuracy (AUC=0.885; sensitivity 92.7%; specificity 74%), suggesting a more effective risk categorization system.

Conclusion: The integration of CEUS into the European TI-RADS provides a more comprehensive diagnostic tool, improving the precision of thyroid cancer diagnosis and malignancy risk assessment.