The rising incidence of identified thyroid nodules has contributed to the overdiagnosis of thyroid cancer, with many patients undergoing unnecessary surgery for investigational purposes. Ultrasound is the most frequent imaging modality performed for these nodules. Inconsistent and subjective reporting has led to the popularization of standardized ultrasound reporting systems. The 2015 American Thyroid Association (ATA) guidelines and the 2017 American College of Radiology Thyroid Imaging Reporting and Data System (ACR TI-RADS) have emerged as the most commonly used frameworks to identify distinguish suspicious and low-risk thyroid nodules in a consistent manner. Nonetheless, the utilization of these systems is variable across different healthcare systems and practitioners. This project investigates the implementation of standardized ultrasound reporting systems in a large, publicly funded, provincial healthcare system.
A cross-sectional survey was performed targeting all provincial outpatient radiology facilities to determine the prevalence of standardized reporting for thyroid ultrasounds. The survey outlined various features of the radiology facility including the use of a standardized thyroid reporting system, the year of implementation, previous attempts to standardize, and the barriers to standardization.
Of the 440 radiology facilities surveyed, 169 centers (38.4%) responded. Of these, 127 facilities used a standardized system (75.1%), which included 114 centers using ACR-TIRADS (90%) and 15 centers using ATA (10%). The majority of respondents implemented a standardized reporting system between 2017-2019 (90.6%). Of the 114 radiology facilities currently using ACR-TIRADS, 32 centers (28.1%) updated to this system from the ATA scheme.
Within a publicly funded healthcare system, most centers have only recently adopted a standardized reporting system for thyroid ultrasounds. We found that ACR-TIRADS was preferred both as the first adopted standard framework among radiology facilities, as well as after a period of using the ATA scheme. As clinical thyroidologists perform more thyroid ultrasounds, the implementation of an effective and practical standard tool should be considered, and ACR-TIRADS maybe a suitable option.Ralph Hsiao poster