AUTHOR=Zhou Ling , Zheng Lin-lin , Zhang Chuan-ju , Wei Hong-fen , Xu Li-long , Zhang Mu-rui , Li Qiang , He Gao-fei , Ghamor-Amegavi Edem Prince , Li Shi-yan 

TITLE=Comparison of S-Detect and thyroid imaging reporting and data system classifications in the diagnosis of cytologically indeterminate thyroid nodules

JOURNAL=Frontiers in Endocrinology

VOLUME=14

YEAR=2023

URL=https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2023.1098031

DOI=10.3389/fendo.2023.1098031

ISSN=1664-2392

ABSTRACT=<sec><title>Purpose</title><p>The aim of this study was to investigate the value of S-Detect for predicting the malignant risk of cytologically indeterminate thyroid nodules (CITNs).</p></sec><sec><title>Methods</title><p>The preoperative prediction of 159 CITNs (Bethesda III, IV and V) were performed using S-Detect, Thyroid Imaging Reporting and Data System of American College of Radiology (ACR TI-RADS) and Chinese TI-RADS (C-TIRADS). First, Linear-by-Linear Association test and chi-square test were used to analyze the malignant risk of CITNs. McNemar’s test and receiver operating characteristic curve were used to compare the diagnostic efficacy of S-Detect and the two TI-RADS classifications for CITNs. In addition, the McNemar’s test was used to compare the diagnostic accuracy of the above three methods for different pathological types of nodules.</p></sec><sec><title>Results</title><p>The maximum diameter of the benign nodules was significantly larger than that of malignant nodules [0.88(0.57-1.42) vs 0.57(0.46-0.81), <italic>P</italic>=0.002]. The risk of malignant CITNs in Bethesda system and the two TI-RADS classifications increased with grade (all <italic>P</italic> for trend&lt;0.001). In all the enrolled CITNs, the diagnostic results of S-Detect were significantly different from those of ACR TI-RADS and C-TIRADS, respectively (<italic>P</italic>=0.021 and <italic>P</italic>=0.007). The sensitivity and accuracy of S-Detect [95.9%(90.1%-98.5%) and 88.1%(81.7%-92.5%)] were higher than those of ACR TI-RADS [87.6%(80.1%-92.7%) and 81.8%(74.7%-87.3%)] (<italic>P</italic>=0.006 and <italic>P</italic>=0.021) and C-TIRADS [84.3%(76.3%-90.0%) and 78.6%(71.3%-84.5%)] (<italic>P</italic>=0.001 and <italic>P</italic>=0.001). Moreover, the negative predictive value and the area under curve value of S-Detect [82.8% (63.5%-93.5%) and 0.795%(0.724%-0.855%)] was higher than that of C-TIRADS [54.8%(38.8%-69.8%) and 0.724%(0.648%-0.792%] (<italic>P</italic>=0.024 and <italic>P</italic>=0.035). However, the specificity and positive predictive value of S-Detect were similar to those of ACR TI-RADS (<italic>P</italic>=1.000 and <italic>P</italic>=0.154) and C-TIRADS (<italic>P</italic>=1.000 and <italic>P</italic>=0.072). There was no significant difference in all the evaluated indicators between ACR TI-RADS and C-TIRADS (all <italic>P</italic>&gt;0.05). The diagnostic accuracy of S-Detect (97.4%) for papillary thyroid carcinoma (PTC) was higher than that of ACR TI-RADS (90.4%) and C-TIRADS (87.8%) (<italic>P</italic>=0.021 and <italic>P</italic>=0.003).</p></sec><sec><title>Conclusion</title><p>The diagnostic performance of S-Detect in differentiating CITNs was similar to ACR TI-RADS and superior to C-TIRADS, especially for PTC.</p></sec>