Observation Variation in Ultrasonography Assessment of Thyroid Nodules

Objective(s): Accurate detection and competent management of thyroid nodules, as a common disease, basically depends on the reliability of the ultrasonography (US) report. In this research, we evaluated inter and intra-observer variation among ultrasonography reporters, based on ACR-TIRADS.Methods: In this retrospective study, ۳۴۵ thyroid US images of ۱۵۰ patients were reviewed. Three clinicians with at least ۶-year experience in thyroid US reviewed the images twice at ۶-۸ weeks’ intervals. Composition, echogenicity, shape, margin, and echogenic foci based on ACR-TIRADS were reported, independently. Inter and intra-observer variations were calculated based on Cohen’s Kappa statistics.Results: ۳۴۵ ultrasonography images of ۱۵۰ patients with thyroid nodules (۸۳ women and ۶۷ men) with a mean age of ۶۵ years were reviewed. Moderate to the substantial intra-observer agreement was achieved with the highest Kapa value in the category of shape (k=۰.۶۱-۰.۷۷). For TIRADS level, the moderate intra-observer agreement was observed (k=۰.۴۲-۰.۴۶). Inter-observer agreement for the US category of thyroid nodules was obtained slightly to moderate. Composition (k=۰.۴۲ and ۰.۵۱) and echogenicity (k=۰.۴۵ and ۰.۴۶) showed the highest overall agreement and margin showed the lowest overall agreement (k=۰.۱۸ and ۰.۱۹). In assessing TIRADS level of nodules, a fair agreement was obtained (k=۰.۲۳ and ۰.۲۹) .Conclusion: Moderate to substantial intra-observer agreement and slight to moderate inter-observer variation for evaluation of thyroid nodules; shows the need for a computer-aided diagnosis system based on artificial intelligence to assist our physicians in differentiating thyroid nodule characteristics based on explicit image features. An additional training course based on ACR-TIRADS for physicians can be another useful recommendation.

کلیدواژه ها:

Inter-observer agreement ، intra-observer agreement ، observation variation ، Ultrasonography ، Thyroid nodules