Systematic Review and Meta-Analysis of American College of Radiology TI-RADS Inter-Reader Reliability for Risk Stratification of Thyroid Nodules

PurposeTo investigate the inter-reader agreement of using the American College of Radiology (ACR) Thyroid Imaging Reporting and Data System (TI-RADS) for risk stratification of thyroid nodules.MethodsA literature search of Web of Science, PubMed, Cochrane Library, EMBASE, and Google Scholar was perf...

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Main Authors: Wei Li, Yuan Sun, Haibing Xu, Wenwen Shang, Anding Dong
Format: Article
Language:English
Published: Frontiers Media S.A. 2022-05-01
Series:Frontiers in Oncology
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fonc.2022.840516/full
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author Wei Li
Yuan Sun
Haibing Xu
Wenwen Shang
Anding Dong
author_facet Wei Li
Yuan Sun
Haibing Xu
Wenwen Shang
Anding Dong
author_sort Wei Li
collection DOAJ
description PurposeTo investigate the inter-reader agreement of using the American College of Radiology (ACR) Thyroid Imaging Reporting and Data System (TI-RADS) for risk stratification of thyroid nodules.MethodsA literature search of Web of Science, PubMed, Cochrane Library, EMBASE, and Google Scholar was performed to identify eligible articles published from inception until October 31, 2021. We included studies reporting inter-reader agreement of different radiologists who applied ACR TI-RADS for the classification of thyroid nodules. Quality assessment of the included studies was performed with the Quality Assessment of Diagnostic Accuracy Studies-2 tool and Guidelines for Reporting Reliability and Agreement Studies. The summary estimates of the inter-reader agreement were pooled with the random-effects model, and multiple subgroup analyses and meta-regression were performed to investigate various clinical settings.ResultsA total of 13 studies comprising 5,238 nodules were included in the current meta-analysis and systematic review. The pooled inter-reader agreement for overall ACR TI-RADS classification was moderate (κ = 0.51, 95% CI 0.42–0.59). Substantial heterogeneity was presented throughout the studies, and meta-regression analyses suggested that the malignant rate was the significant factor. Regarding the ultrasound (US) features, the best inter-reader agreement was composition (κ = 0.58, 95% CI 0.53–0.63), followed by shape (κ = 0.57, 95% CI 0.41–0.72), echogenicity (κ = 0.50, 95% CI 0.40–0.60), echogenic foci (κ = 0.44, 95% CI 0.36–0.53), and margin (κ = 0.34, 95% CI 0.24–0.44).ConclusionsThe ACR TI-RADS demonstrated moderate inter-reader agreement between radiologists for the overall classification. However, the US feature of margin only showed fair inter-reader reliability among different observers.
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spelling doaj.art-34837d9282444046a3a5882700a2d47e2022-12-22T03:23:27ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2022-05-011210.3389/fonc.2022.840516840516Systematic Review and Meta-Analysis of American College of Radiology TI-RADS Inter-Reader Reliability for Risk Stratification of Thyroid NodulesWei Li0Yuan Sun1Haibing Xu2Wenwen Shang3Anding Dong4Department of Medical Imaging, Jiangsu Vocational College of Medicine, Yancheng, ChinaDepartment of Burn and Plastic Surgery, Affiliate Huaihai Hospital of Xuzhou Medical University, Xuzhou, ChinaDepartment of Medical Imaging, Jiangsu Vocational College of Medicine, Yancheng, ChinaDepartment of Medical Imaging, Jiangsu Vocational College of Medicine, Yancheng, ChinaDepartment of Medical Imaging, Jiangsu Vocational College of Medicine, Yancheng, ChinaPurposeTo investigate the inter-reader agreement of using the American College of Radiology (ACR) Thyroid Imaging Reporting and Data System (TI-RADS) for risk stratification of thyroid nodules.MethodsA literature search of Web of Science, PubMed, Cochrane Library, EMBASE, and Google Scholar was performed to identify eligible articles published from inception until October 31, 2021. We included studies reporting inter-reader agreement of different radiologists who applied ACR TI-RADS for the classification of thyroid nodules. Quality assessment of the included studies was performed with the Quality Assessment of Diagnostic Accuracy Studies-2 tool and Guidelines for Reporting Reliability and Agreement Studies. The summary estimates of the inter-reader agreement were pooled with the random-effects model, and multiple subgroup analyses and meta-regression were performed to investigate various clinical settings.ResultsA total of 13 studies comprising 5,238 nodules were included in the current meta-analysis and systematic review. The pooled inter-reader agreement for overall ACR TI-RADS classification was moderate (κ = 0.51, 95% CI 0.42–0.59). Substantial heterogeneity was presented throughout the studies, and meta-regression analyses suggested that the malignant rate was the significant factor. Regarding the ultrasound (US) features, the best inter-reader agreement was composition (κ = 0.58, 95% CI 0.53–0.63), followed by shape (κ = 0.57, 95% CI 0.41–0.72), echogenicity (κ = 0.50, 95% CI 0.40–0.60), echogenic foci (κ = 0.44, 95% CI 0.36–0.53), and margin (κ = 0.34, 95% CI 0.24–0.44).ConclusionsThe ACR TI-RADS demonstrated moderate inter-reader agreement between radiologists for the overall classification. However, the US feature of margin only showed fair inter-reader reliability among different observers.https://www.frontiersin.org/articles/10.3389/fonc.2022.840516/fullthyroid noduleultrasonographyreproducibility of resultsclassificationmeta-analysis
spellingShingle Wei Li
Yuan Sun
Haibing Xu
Wenwen Shang
Anding Dong
Systematic Review and Meta-Analysis of American College of Radiology TI-RADS Inter-Reader Reliability for Risk Stratification of Thyroid Nodules
Frontiers in Oncology
thyroid nodule
ultrasonography
reproducibility of results
classification
meta-analysis
title Systematic Review and Meta-Analysis of American College of Radiology TI-RADS Inter-Reader Reliability for Risk Stratification of Thyroid Nodules
title_full Systematic Review and Meta-Analysis of American College of Radiology TI-RADS Inter-Reader Reliability for Risk Stratification of Thyroid Nodules
title_fullStr Systematic Review and Meta-Analysis of American College of Radiology TI-RADS Inter-Reader Reliability for Risk Stratification of Thyroid Nodules
title_full_unstemmed Systematic Review and Meta-Analysis of American College of Radiology TI-RADS Inter-Reader Reliability for Risk Stratification of Thyroid Nodules
title_short Systematic Review and Meta-Analysis of American College of Radiology TI-RADS Inter-Reader Reliability for Risk Stratification of Thyroid Nodules
title_sort systematic review and meta analysis of american college of radiology ti rads inter reader reliability for risk stratification of thyroid nodules
topic thyroid nodule
ultrasonography
reproducibility of results
classification
meta-analysis
url https://www.frontiersin.org/articles/10.3389/fonc.2022.840516/full
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