Study of French inter-expert variability in thyroid nodule ultrasound

Objective: Thyroid nodule ultrasound, conducted in France using the EU-TIRADS framework, is an essential tool for the management of these potentially malignant lesions. However, recent studies have suggested significant inter-reader variability in the description of sonographic features that form the foundation of EU-TIRADS scoring. To assess the impact of this variability in France, this work examines inter-reader differences among experienced French practitioners in assigning EU-TIRADS scores and sonographic feature labels to images acquired during routine clinical practice.

Methods: A total of 303 axial-view ultrasound images of thyroid nodules were collected from four practice sites in France, including both private clinics and university hospitals. Each image was reviewed independently by four experts with at least 15 years of experience, who assigned both sonographic feature labels and an EU-TIRADS score to it. The inter-reader variability was assessed for each score and label, along with an evaluation of individual expert tendencies.

Results: The results indicate a substantial degree of inter-expert variability in both the identification of individual features and the assignment of an EU-TIRADS score. The most heavily marked disagreements concerned nodule echogenicity, the presence of punctate echogenic foci, and nodule shape.

Conclusions: Our findings suggest that the current state of practice for ultrasound-based thyroid nodule diagnosis in France may suffer from substantial inter-expert variability in the identification of key sonographic features and the attribution of EU-TIRADS scores.