Original Research

American College of Radiology Thyroid Imaging Reporting and Data System standardises reporting of thyroid ultrasounds

Mariska Botha, Margaret Kisansa, Wim Greeff
South African Journal of Radiology | Vol 24, No 1 | a1804 | DOI: https://doi.org/10.4102/sajr.v24i1.1804 | © 2020 Mariska Botha, Margaret Kisansa, Wim Greeff | This work is licensed under CC Attribution 4.0
Submitted: 24 September 2019 | Published: 06 February 2020

About the author(s)

Mariska Botha, Department of Health, Faculty of Radiology, Sefako Makgatho Health Sciences University, Pretoria, South Africa
Margaret Kisansa, Department of Health, Faculty of Radiology, Sefako Makgatho Health Sciences University, Pretoria, South Africa
Wim Greeff, Department of Health, Faculty of Radiology, Sefako Makgatho Health Sciences University, Pretoria, South Africa


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Abstract

Background: Thyroid nodules are common, the majority benign. The small risk of malignancy leads to excessive workup. Thyroid ultrasound is essential for risk stratification and management guidance. Without an organised reporting guideline, reports do not add significant value to referring clinicians. The American College of Radiology Thyroid Imaging Reporting and Data System (ACR TI-RADS) was developed to aid ultrasound reporting, lessen excessive biopsies and diagnose thyroid cancers.

Objectives: To standardise reporting of thyroid ultrasounds by utilising an organised reporting guideline based on ACR TI-RADS.

Method: Thyroid ultrasound reports generated by radiology registrars at an academic hospital were studied in two phases. In Phase 1, the reports were generated as free text, and in Phase 2, using a guideline based on ACR TI-RADS. The percentages of reports that described the maximum size, the five ACR TI-RADS features and a management recommendation were compared.

Results: A total of 130 reports were studied. Significant improvement was observed in the description of all five ACR TI-RADS categories (p < 0.0001) from Phase 1 to Phase 2. Of all the reports, 89% included a management recommendation. Reports including an ACR TI-RADS-based recommendation increased from 48% to 75% (p < 0.05). Recommendation for biopsy increased from 35.4% to 53.8% (p < 0.05).

Conclusion: Introduction of an organised reporting guideline based on ACR TI-RADS, standardised reporting of thyroid ultrasounds by increasing description of thyroid nodule features and ensuring appropriate management recommendations. This, in future, will prevent underdiagnosis of thyroid cancer and unnecessary workup of benign nodules.


Keywords

thyroid ultrasound; ACR TI-RADS; thyroid nodules; reporting standard; thyroid biopsy; thyroid fine needle aspiration (FNA); improved quality of reports; thyroid sonar; thyroid cancer; thyroid malignancy.

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