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Purpose <p>This study aimed to investigate the influence of thyroid nodule size on the diagnostic efficacy of the Chinese thyroid imaging reporting and data system (C-TIRADS).</p> Patients and Methods <p>This retrospective study included pathologically confirmed thyroid nodules categorized into ≤ 10&#xa0;mm and &gt; 10&#xa0;mm groups. The ultrasound characteristics of these nodules were evaluated, and C-TIRADS scoring and classification were performed. Receiver operating characteristic (ROC) curves were generated to ascertain optimal threshold values for scoring and classification in both groups. Subsequently, the diagnostic accuracies of C-TIRADS for thyroid nodules in the two groups were compared.</p> Results <p>The ≤ 10&#xa0;mm group included 237 benign, 1 low-risk, and 1,376 malignant nodules. The &gt; 10&#xa0;mm group included 499 benign, 13 low-risk, and 349 malignant nodules. The Mann–Whitney U test results revealed that scores for malignant thyroid nodules were significantly ˃ those for benign nodules in both groups. The ROC curves (AUC) for C-TIRADS scoring and classification in the ≤ 10&#xa0;mm group were 0.707 and 0.684, respectively, with optimal threshold values of &gt; 2 points and &gt; C-TR 4B. In the &gt; 10&#xa0;mm group, AUCs for C-TIRADS scoring and classification were 0.927 and 0.922, respectively, with optimal threshold values of &gt; 1 point and &gt; C-TR of 4A. The &gt; 10&#xa0;mm group had greater specificity, negative predictive value (NPV) and accuracy than the ≤ 10&#xa0;mm group, whereas the &gt; 10&#xa0;mm group had lower positive predictive value (PPV) than the ≤ 10&#xa0;mm group at these optimal thresholds (all P-values &lt; 0.001).</p> Conclusion <p>The diagnostic performance of C-TIRADS scoring and classification was significantly lower for thyroid nodules with a diameter of ≤ 10&#xa0;mm than for those with a diameter of &gt; 10&#xa0;mm.</p>

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Nodule size significantly affects the diagnostic value of chinese thyroid imaging reporting and data system: a multi-center retrospective study

  • 期刊论文

  • 发表日期：

    2026年3月28日

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  • Hu Huang,
  • Qi Gao,
  • Hong-jian Li,
  • Qi-yuan Li,
  • Wei-min Li

摘要

Purpose

This study aimed to investigate the influence of thyroid nodule size on the diagnostic efficacy of the Chinese thyroid imaging reporting and data system (C-TIRADS).

Patients and Methods

This retrospective study included pathologically confirmed thyroid nodules categorized into ≤ 10 mm and > 10 mm groups. The ultrasound characteristics of these nodules were evaluated, and C-TIRADS scoring and classification were performed. Receiver operating characteristic (ROC) curves were generated to ascertain optimal threshold values for scoring and classification in both groups. Subsequently, the diagnostic accuracies of C-TIRADS for thyroid nodules in the two groups were compared.

Results

The ≤ 10 mm group included 237 benign, 1 low-risk, and 1,376 malignant nodules. The > 10 mm group included 499 benign, 13 low-risk, and 349 malignant nodules. The Mann–Whitney U test results revealed that scores for malignant thyroid nodules were significantly ˃ those for benign nodules in both groups. The ROC curves (AUC) for C-TIRADS scoring and classification in the ≤ 10 mm group were 0.707 and 0.684, respectively, with optimal threshold values of > 2 points and > C-TR 4B. In the > 10 mm group, AUCs for C-TIRADS scoring and classification were 0.927 and 0.922, respectively, with optimal threshold values of > 1 point and > C-TR of 4A. The > 10 mm group had greater specificity, negative predictive value (NPV) and accuracy than the ≤ 10 mm group, whereas the > 10 mm group had lower positive predictive value (PPV) than the ≤ 10 mm group at these optimal thresholds (all P-values < 0.001).

Conclusion

The diagnostic performance of C-TIRADS scoring and classification was significantly lower for thyroid nodules with a diameter of ≤ 10 mm than for those with a diameter of > 10 mm.