Оn the need to introduce the TI-RADS classification in Russia
Elena P. Fisenko,
Alexander N. Sencha,
Alexey N. Katrich,
Yulia P. Sych,
Nadezhda V. Tsvetkova,
Alexey V. Borsukov,
Ekaterina V. Kostromina 
Abstract
An active discussion of TI-RADS modifications (Thyroid Imaging Reporting And Diagnostic System) classification continues in the world professional medical community. This system of thyroid nodules stratification on the malignancy signs is intended primarily to select thyroid nodules for a fine needle aspiration biopsy. The classification should be uniform for all medical institutions of our country, easy to use and understandable by various medical specialists. This article presents a modification of TI-RADS prepared for discussion in the professional communities of Russia. Some “major” ultrasound features of malignancy (with specificity >95%) and additional or “minor” features (with specificity >90%) of thyroid nodules are pointed out to emphasise the need of fine needle biopsy. After comparison of diagnostic parameters of proposed TI-RADS and European TIRADS (EU-TIRADS), both systems showed comparable specificity of 93%, while sensitivity of proposed TI-RADS was slightly higher than for EU-TIRADS, with 94.2% and 91.0%, respectively. This discrepancy may be related to “minor” features of malignancy which were taken into consideration.
About the Authors
Elena P. FisenkoPetrovsky National Research Centre of Surgery; I.M. Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation
MD, PhD
Alexander N. Sencha
Research Center for Obstetrics, Gynecology and Perinatology
Russian Federation
MD, PhD
Alexey N. Katrich
Scientific Research Institute – Regional Clinic Hospital №1 named after Professor S.V. Ochapovsky; Kuban State Medical University
Russian Federation
MD, PhD
Yulia P. Sych
I.M. Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation
MD, PhD
Nadezhda V. Tsvetkova
Tver State Medical University
Russian Federation
MD, PhD, Associate Professor
Alexey V. Borsukov
Smolensk State Medical University
Russian Federation
MD PhD, Professor, head of Problem research laboratory "Diagnostic research and minimally invasive technologies"
Ekaterina V. Kostromina
N.N. Petrov National Medical Research Centre of Oncology; St. Petersburg Pediatric University
Russian Federation
MD, PhD
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1. рисунок 1А к статье TIRADS_КЭТ | |
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5. рисунок 3А к статье TIRADS_КЭТ | |
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7. рисунок 3Вк статье TIRADS_КЭТ | |
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8. рисунок 3Г к статье TIRADS_КЭТ | |
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9. рисунок 4А к статье TIRADS_КЭТ | |
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10. рисунок 4Б к статье TIRADS_КЭТ | |
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11. рисунок 4B к статье TIRADS_КЭТ | |
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12. рисунок 4Г к статье TIRADS_КЭТ | |
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13. рисунок 4Д к статье TIRADS_КЭТ | |
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14. рисунок 5А к статье TIRADS_КЭТ | |
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15. рисунок 5Б к статье TIRADS_КЭТ | |
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16. Fig. 1. Category TI-RADS 2: a - cystically dilated or macrofollicle; b - spongy node (arrows). | |
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17. Fig. 2. TI-RADS 3 category: а - isoechogenic focus (arrows), surrounded by a thin halo (nodular goiter); b - a hyperechoic lesion of a rounded shape, with clear contours, a thin hypoechoic rim on the background of autoimmune thyroiditis; c - calcined knot by the type of “egg shell”. | |
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18. Fig. 3. TI-RADS 4: a - spherical site, with smooth and clear contours, moderately reduced echogenicity, with areas of lower echo, with macrocalcinate. The node is surrounded by a thin halo (follicular neoplasia); b, c, d (transverse and longitudinal scanning of the left lobe of the thyroid gland) - isoechogenic nodes with hypoechoic inclusions, with clear contours, with a thin halo (follicular adenoma); d - isoechoic node with hypoechoic inclusions, with unevenly thickened halo (follicular cancer). | |
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19. Fig. 4. TI-RADS 5. Thyroid nodes> 1.0 cm in size (papillary cancers): a, b - nodes of significantly reduced echogenicity with microcalcifications, with uneven microlobular contours; c - a node of vertical spatial orientation, with fuzzy, uneven contours, significantly reduced echogenicity, with multiple microcalcifications; g - a node with microlobular fuzzy contours, unevenly reduced echogenicity, with microcalcifications; d - a node of significantly reduced echogenicity, vertical spatial orientation, with fuzzy, uneven (radiant) contours; e - a node with fuzzy contours, with multiple microcalcifications. | |
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20. Fig. 5. TI-RADS 5. Thyroid nodes <1.0 cm in size: a - node with fuzzy and uneven radiant contours, vertical spatial orientation, significantly reduced echogenicity, with microcalcifications; b - a node of spherical shape, with fuzzy, blurry, uneven microlobular contours, moderately reduced echogenicity, with microcalcifications, grows to the thyroid capsule, deforming the external contour of the lobe. Cytologically and histologically in all presented nodes, papillary cancer was diagnosed. | |
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For citations:
Fisenko E.P., Sencha A.N., Katrich A.N., Sych Yu.P., Tsvetkova N.V., Borsukov A.V., Kostromina E.V. Оn the need to introduce the TI-RADS classification in Russia. Clinical and experimental thyroidology. 2019;15(2):55-63. (In Russ.)
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