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J Am Coll Radiol. 2018 May;15(5):743-748. doi: 10.1016/j.jacr.2018.01.024. Epub 2018 Mar 2.

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

Author information

1
Department of Radiology, Duke University Medical Center, Durham, North Carolina.
2
Radiology Partners, Portland, Oregon.
3
Radiology Partners, El Segundo, California.
4
Radiology Partners Research Institute, El Segundo, California.
5
Department of Radiology, University of Alabama at Birmingham, Birmingham, Alabama.
6
Department of Radiology, Duke University Medical Center, Durham, North Carolina. Electronic address: jennykh@gmail.com.

Abstract

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.

PMID:
29503150
DOI:
10.1016/j.jacr.2018.01.024
[Indexed for MEDLINE]

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