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September 2, 2026Journal of Diabetes and Endocrine PracticeOpen Access

Comparison of ACR TI-RADS and ATA Ultrasound Risk Stratification for Thyroid Nodules – Data from a Tertiary Hospital in the United Arab Emirates

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Authors

SESamer El-KaissiCleveland ClinicEVEric VensIllinois CollegeSGSafieeldin GhazalaSaad Specialist Hospital

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Overview

Retrospective study reveals ACR TI-RADS provides superior specificity over ATA guidelines for thyroid nodules, indicating significant reductions in unnecessary biopsies.

Key Points

  • Compare the diagnostic performance and independent predictive value for malignancy between the ATA-RSS and ACR TI-RADS ultrasound classification systems in patients with thyroid nodules.
  • Retrospectively analyzed 557 patients with 693 thyroid nodules undergoing fine-needle aspiration biopsy at a tertiary hospital in the United Arab Emirates.
  • Established malignancy using a composite reference standard consisting of surgical histopathology (n = 151, 21.8%) or Bethesda category VI cytology.
  • Assessed sensitivity, specificity, predictive values, and executed multivariate logistic regression adjusted for age, sex, and nodule size.
  • ATA-RSS recommended biopsy for 90.5% of nodules yielding 96.2% sensitivity, 10.5% specificity, and 16.1% PPV, whereas ACR TI-RADS recommended biopsy for 53.7% with 89.5% sensitivity, 52.7% specificity, and 25.3% PPV.
  • Multivariate regression confirmed both systems as independent predictors of malignancy (15.2% overall rate), with ACR TI-RADS showing greater discrimination (OR = 23.2, 95% CI: 10.2–52.9, p < 0.001) compared to ATA-RSS (OR = 6.0, 95% CI: 1.5–23.5, p = 0.01).

Cite This Study

El-Kaissi et al. (2026) studied this question.

synapsesocial.com/papers/6a97e305c562ede874ec787ahttps://doi.org/10.1055/s-0046-1825860
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1A Comparative Analysis of TIRADS and ATA Classification Systems in Determining the Malignancy of Thyroid Nodules2026
  2. 2Validation of TIRADS ACR Risk Assessment of Thyroid Nodules in Comparison to the ATA Guidelines2021 · 24 citations
  3. 3Comparison of ACR-TIRADS to the ATA Guidelines for Thyroid Nodules: A Neck to Neck Comparison2022 · 2 citations
  4. 4Comparison of the Diagnostic Performance of ACR TI-RADS and EU-TI-RADS for the Detection of Thyroid Malignancy: A Retrospective Study2026
  5. 5Diagnostic performance of the ACR TI-RADS classification in identifying and excluding thyroid malignancy: a multi-correlative retrospective study in a South African tertiary hospital2025