Improved Quality of Thyroid Ultrasound Reports After Implementation of the ACR Thyroid Imaging Reporting and Data System Nodule Lexicon and Risk Stratification System.


Journal Article

PURPOSE:The aim of this study was to compare the description and management recommendations for thyroid nodules before and after implementing a structured reporting template based on the ACR Thyroid Imaging Reporting and Data System (TI-RADS). METHODS:Thyroid ultrasound reports for seven private practice radiologists were analyzed in three phases. In phase 1, radiologists dictated in a free-text format. In phase 2, they used a structured reporting template based on the ACR TI-RADS lexicon, but without the ACR TI-RADS recommendations for nodule management. In phase 3, ACR TI-RADS management recommendations were added. The most suspicious thyroid nodule in each report was analyzed for size, features, and management recommendations in all three phases. RESULTS:Seventy-one thyroid ultrasound reports were reviewed for each phase, for a total of 213 reports. In phase 1, reports did not describe the features of the majority of nodules. In particular, shape and margin were not reported for 100% and 92% of nodules, respectively. Ninety-six percent to 100% of nodules had descriptions of all five features in phases 2 and 3. The number of nodules without management recommendations was 34% in phase 1 and 31% in phase 2. It decreased to 6% in phase 3 (P < .0005). CONCLUSIONS:Implementing an ACR TI-RADS structured reporting template improved the quality of thyroid ultrasound reports in two key ways. A structured reporting template led to better description of features that are predictive of malignancy. The use of ACR TI-RADS management guidelines substantially improved the number of reports with definitive management recommendations.

Full Text

Cited Authors

  • Griffin, AS; Mitsky, J; Rawal, U; Bronner, AJ; Tessler, FN; Hoang, JK

Published Date

  • May 2018

Published In

Volume / Issue

  • 15 / 5

Start / End Page

  • 743 - 748

PubMed ID

  • 29503150

Pubmed Central ID

  • 29503150

Electronic International Standard Serial Number (EISSN)

  • 1558-349X

International Standard Serial Number (ISSN)

  • 1546-1440

Digital Object Identifier (DOI)

  • 10.1016/j.jacr.2018.01.024


  • eng