Published online Jan 28, 2022. doi: 10.4329/wjr.v14.i1.19
Peer-review started: October 12, 2021
First decision: December 9, 2021
Revised: December 21, 2021
Accepted: January 11, 2022
Article in press: January 11, 2022
Published online: January 28, 2022
Thyroid nodules are common and often incidental. The American College of Radiology Thyroid Imaging Reporting and Data System (ACR TI-RADS) standardizes the use of ultrasound for thyroid nodule risk stratification.
Despite the widespread usage of this system, the learnability of TI-RADS has not been proven in radiology trainees.
To evaluate the inter-reader reliability amongst radiology trainees before and after TI-RADS training.
Three PGY-4 radiology residents were evaluated for inter-reader reliability with a 50 thyroid nodule data set before and after a 1-hour didactic teaching session and review of a training data set, with assessment performed 6 wk apart. Performance was compared to a consensus panel reference standard of three fellowship trained radiologists.
After one session of dedicated TI-RADS training, the radiology residents demonstrated statistically significant improvement in inter-reader agreement in subcategories of "shape", "echogenic foci", "TI-RADS level", and "recommendations" when compared with expert panel consensus. A trend towards higher pooled sensitivity for TI-RADS level 1-4 is also observed.
Resident trainees demonstrated a statistically significant improvement in inter-reader agreement for both TI-RADS level and recommendations after training. This study demonstrates the learnability of the ACR TI-RADS.
A multi-institutional and multi-national assessment of radiology resident diagnostic accuracy and inter-reader reliability of ACR TI-RADS classification and recommendations before and after training would improve the generalizability of these results.