Description of error and impact
After the publication of this article, an internal database tracking review revealed that raw data spreadsheet columns had been cross-linked non-synchronously across multiple tracking matrices. This compilation oversight led to an inaccurate initial division of benign versus malignant historical groups. The overall study size remains fixed at 149 adult patients.
The corrected distribution confirms 68 malignant cases (45.64%) and 81 benign cases (54.36%), rather than the previously reported 50 malignant (33.56%) and 99 benign (66.44%) cases. These baseline tracking shifts alter corresponding numerical risks, crude and adjusted odds ratios, diagnostic performance metric percentages, and matching 95% confidence intervals across the text, figures, and tables.
The core clinical conclusions are updated to reflect that TIRADS categories 3–5 did not reach independent statistical significance in multivariable logistic regression analyses. These adjustments do not affect the clinical utility of ultrasound monitoring protocols, nor do they alter the academic validity of the study.
Corrections to the abstract
Results: “Among the 149 nodules examined, 50 (33.56%) were confirmed to be malignant via histopathology, while 99 (66.44%) were benign… solid composition adjusted OR 4.912… Risk of malignancy for TIRADS categories 3, 4a, 4b, 4c and 5 were 12.50%, 12.82%, 26.19%, 53.70% and 66.67%, respectively… Crude OR for 4a, 4b, 4c, 5 were 1.03, 2.48, 8.12, 14.0… Sensitivity 98.00%, Specificity 7.07%, PPV 34.75%, NPV 87.50%, Accuracy 53%” is corrected to “Among the 149 nodules examined, 68 (45.64%) were malignant and 81 (54.36%) were benign. Solid composition was significantly associated with malignancy. The overall diagnostic indices were as follows: sensitivity 95.59% (95% CI 87.64–99.08), specificity 7.41% (95% CI 2.77–15.43), PPV 46.43% (95% CI 37.97–55.05), NPV 66.67% (95% CI 29.93–92.51), positive LR 1.03 (95% CI 0.95–1.12), negative LR 0.60 (95% CI 0.15–2.29), and overall accuracy 47.65% (95% CI 39.41–55.98).”
Conclusion: “Higher TIRADS classification is associated with higher risk of thyroid malignancy. TIRADS is a sensitive classification in recognizing patients with thyroid cancer.” is corrected to “TIRADS categories 3–5 were not significantly associated with malignancy on logistic regression analysis. While TIRADS demonstrated high sensitivity (96%), its very low specificity (7%) limits its ability to reliably distinguish malignant from benign nodules, indicating that it should be used cautiously and in conjunction with other diagnostic tools.”
Corrections to the main text
Study Population and Clinico-Demographic Characteristics: “Among these, 50 (33.56%) had histopathologically confirmed malignant nodules, while 99 (66.44%) had benign lesions” is corrected to “Among these, 68 (45.64%) had histopathologically confirmed malignant nodules, while 81 (54.36%) had benign lesions (Figure 1).”
Factors associated with malignancy and risk by TIRADS category: “Malignancy risks for TIRADS categories 3, 4a, 4b, 4c, and 5 were 12.50%, 12.82%, 26.19%, 53.70%, and 66.67%, respectively… Crude OR for 4a, 4b, 4c, 5 were: 1.03, 2.48, 8.12, 14.0…” is corrected to “Malignancy risks for TIRADS categories 3, 4a, 4b, 4c, and 5 were 33.33%, 36.84%, 38.10%, 57.41%, and 66.67%, respectively (Table 3). The cORs comparing TIRADS categories 4a, 4b, 4c, and 5 to category 3 were 1.17 (95% CI 0.26–6.21), 1.23 (95% CI 0.28–6.48), 2.70 (95% CI 0.64–13.85), and 4.00 (95% CI 0.48–44.25), respectively. Despite this apparent increase in risk, the differences in TIRADS grading distribution between malignant and benign nodules were not statistically significant (all p >0.05).”
Diagnostic performance of TIRADS: “On comparing TIRADS results and histopathology, we found that TIRADS 4a to 5 classes had approximately 98% sensitivity, 7.07% specificity, LR+ of 1.05, LR- of 0.28, PPV of 34.75%, NPV of 87.5%, and accuracy of 53%.” is corrected to “TIRADS categories 4a to 5 classified 93.96% of nodules, identifying 95.59% of malignant nodules but also labeling 92.59% of benign nodules as high risk (Table 4). Sensitivity was high at 95.59% (95% CI 87.64–99.08); however, specificity was low at 7.41% (95% CI 2.77–15.43). The PPV, NPV, and overall accuracy were 46.43%, 66.67%, and 47.65%, respectively. The likelihood ratios indicated limited clinical utility (positive LR 1.03; negative LR 0.60), suggesting that TIRADS alone poorly distinguishes benign from malignant nodules despite its high sensitivity.”
Table 3.
TIRADS categories and risk of malignancy of patients who underwent thyroidectomy (n = 149)
| TIRADS Category | CORRECTED | ORIGINAL | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|
|
| ||||||||||
| Histopathology | Risk of Malignancy (%) | cOR (95% CI) | p | Histopathology | Risk of Malignancy (%) | cOR (95% CI) | p | |||
|
|
|
|||||||||
| Benign (n = 81) | Malignant (n = 68) | Benign (n = 99) | Malignant (n = 50) | |||||||
| 3 | 6/9 | 3/9 | 33.33% | reference | - | 7/8 | 1/8 | 12.50% | reference | - |
|
| ||||||||||
| 4a | 24/38 | 14/38 | 36.84% | 1.17 (0.26-6.21) | 0.844 | 34/39 | 5/39 | 12.82% | 1.03 (0.10 to 10.23) | 0.980 |
|
| ||||||||||
| 4b | 26/42 | 16/42 | 38.10% | 1.23 (0.28-6.48) | 0.789 | 31/42 | 11/42 | 38.10% | 2.48 (0.27 to 22.54) | 0.419 |
|
| ||||||||||
| 4c | 23/54 | 31/54 | 57.41% | 2.70 (0.64-13.85) | 0.191 | 25/54 | 29/54 | 57.41% | 8.12 (0.93 to 70.59) | 0.059 |
|
| ||||||||||
| 5 | 2/6 | 4/6 | 66.67% | 4.00 (0.48-44.25) | 0.215 | 2/6 | 4/6 | 66.67% | 14 (0.94 to 207.60) | 0.055 |
Table 4.
Accuracy of TIRADS in predicting a malignant thyroid nodule (n = 149)
| TIRADS | CORRECTED | TIRADS | ORIGINAL | ||||
|---|---|---|---|---|---|---|---|
|
|
|
||||||
| Malignant (n = 68) | Benign (n = 81) | Total | Malignant (n = 50) | Benign (n = 99) | Total | ||
|
| |||||||
| Frequency (%) | |||||||
| TIRADS 4 to 5 | 65 (95.59) | 75 (92.59) | 140 (93.96) | TIRADS 4 to 5 | 49 (98) | 92 (92.93) | 141 (94.63) |
|
| |||||||
| TIRADS 3 | 3 (4.41) | 6 (7.41) | 9 (6.04) | TIRADS 3 | 1 (2) | 7 (7.07) | 8 (5.37) |
|
| |||||||
| Total | 68 (100) | 81 (100) | Total | 50 (100) | 99 (100) | 149 (100) | |
| Sensitivity (%, 95% CI) |
95.59 (87.64, 99.08) |
Positive LR (LR, 95% CI) |
1.03 (0.95, 1.12) |
Sensitivity | 98 (89.35-99.95) |
Positive LR | 1.05 (0.99 to 1.13) |
| Specificity (%, 95% CI) |
7.41 (2.77, 15.43) |
Negative LR (LR, 95% CI) |
0.60 (0.15, 2.29) |
Specificity | 7.07 (2.89 to 14.03) |
Negative LR | 0.28 (0.04 to 2.24) |
| PPV (%, 95% CI) | 46.43 (37.97, 55.05) |
Accuracy (%, 95% CI) |
47.65 (39.41, 55.98) |
PPV | 34.75 (33.24 to 36.29) |
Accuracy | 53% |
| NPV (%, 95% CI) | 66.67 (29.93, 92.51) |
NPV | 87.5 (46.96 to 98.23) |
||||
Corrections to figures and tables
Figure 1 flowchart: The flowchart originally showed a cohort distribution of 99 benign cases and 50 malignant cases. This is corrected to display the updated stratification frequencies: Benign Histopathology total is 81 patients (TIRADS 3 (6 patients), TIRADS 4a (24 patients), TIRADS 4b (26 patients), TIRADS 4c (23 patients), TIRADS 5 (2 patients)); Malignant Histopathology total is 68 patients (TIRADS 3 (3 patients), TIRADS 4a (14 patients), TIRADS 4b (16 patients), TIRADS 4c (31 patients), TIRADS 5 (4 patients)).
Table 2. Association of patient characteristics with malignancy at surgical histopathology (n = 149) corrected to: Table 1. Clinico-demographic profile of the patients (n = 149).
Table 4. Clinical features associated with malignant thyroid nodules at surgical pathology (n = 149) corrected to: Table 2.
Table 5. TIRADS categories and risk of malignancy of patients who underwent thyroidectomy (n = 149) corrected to: Table 3.
Table 6. Accuracy of TIRADS in predicting a malignant thyroid nodule (n = 149) corrected to: Table 4.
Table 1.
Clinico-demographic profile of the patients (n = 149)
| CORRECTED | ORIGINAL | ||||||
|---|---|---|---|---|---|---|---|
|
| |||||||
| All (n = 149) | Benign (n = 81, 54.36%) | Malignant (n = 68, 45.64%) | p | Benign (n = 99) | Malignant (n = 50) | p | |
|
| |||||||
| Median (IQR); Frequency (%) | |||||||
| Age (years) | 47 (36-59) | 49 (36-59) | 44.50 (35.75-57.25) | 0.304 | 47.13 ± 12.91 | 46.46 ± 14.93 | 0.775 |
| <30 | 17 (11.41) | 8 (9.88) | 9 (13.24) | 0.795 | 8 (8.08) | 9 (18) | |
| 30-39 | 34 (22.82) | 16 (19.75) | 18 (26.47) | 26 (26.26) | 8 (16) | 0.040 | |
| 40-49 | 33 (22.15) | 18 (22.22) | 15 (22.06) | 22 (22.22) | 11 (22) | 0.184 | |
| 50-59 | 33 (22.15) | 21 (25.93) | 12 (17.65) | 22 (22.22) | 11 (22) | 0.184 | |
| 60-69 | 29 (19.46) | 16 (19.75) | 13 (19.12) | 19 (19.19) | 10 (20) | 0.223 | |
| ≥70 | 3 (2.01) | 2 (2.47) | 1 (1.47) | 2 (2.02) | 1 (2) | 0.538 | |
|
| |||||||
| Sex | 0.432 | ||||||
| Male | 20 (13.42) | 13 (16.05) | 7 (10.29) | 13 (13.13) | 7 (14) | ||
| Female | 129 (86.58) | 68 (83.95) | 61 (89.71) | 86 (86.87) | 43 (86) | ||
|
| |||||||
| Composition | <0.001 | <0.001 | |||||
| Solid | 93 (62.42) | 40 (49.38) | 53 (77.94) | 49 (49.49) | 44 (88) | ||
| Mixed | 56 (37.58) | 41 (50.62) | 15 (22.06) | 50 (50.51) | 6 (12) | ||
|
| |||||||
| Echogenicity | 0.041 | ||||||
| Hyperechoic or isoechoic | 53 (35.57) | 33 (40.74) | 20 (29.41) | 41 (41.41) | 12 (24) | ||
| Hypoechoic | 56 (37.58) | 33 (40.74) | 23 (33.82) | 38 (38.38) | 18 (36) | 0.269 | |
| Markedly hypoechoic | 40 (26.85) | 15 (18.52) | 25 (36.76) | 20 (20.20) | 20 (40) | 0.007 | |
|
| |||||||
| Margins | 0.141 | ||||||
| Well-circumscribed | 60 (40.27) | 34 (41.98) | 26 (38.24) | 48 (48.48) | 13 (26) | ||
| Microlobulated | 37 (24.83) | 24 (29.63) | 13 (19.12) | 26 (26.26) | 10 (20) | 0.471 | |
| Irregular | 52 (34.90) | 23 (28.40) | 29 (42.65) | 25 (25.25) | 27 (54) | 0.001 | |
|
| |||||||
| Calcifications | 0.011 | ||||||
| Microcalcifications | 36 (24.16) | 19 (23.46) | 17 (25.00) | 20 (20.20) | 16 (32) | ||
| Macrocalcifications | 29 (19.46) | 9 (11.11) | 20 (29.41) | 13 (13.13) | 16 (32) | 0.391 | |
| None | 84 (56.38) | 53 (65.43) | 31 (45.59) | 66 (66.67) | 18 (36) | 0.012 | |
|
| |||||||
| Shape | 0.254 | ||||||
| Wider than tall | 123 (82.55) | 70 (86.42) | 53 (77.94) | 86 (86.87) | 37 (74) | ||
| Taller than wide | 26 (17.45) | 11 (13.58) | 15 (22.06) | 13 (13.13) | 13 (26) | 0.055 | |
|
| |||||||
| TIRADS Category | 0.150 | ||||||
| 3 | 9 (6.04) | 6 (7.41) | 3 (4.41) | ||||
| 4a | 38 (25.50) | 24 (29.63) | 14 (20.59) | ||||
| 4b | 42 (28.19) | 26 (32.10) | 16 (23.53) | ||||
| 4c | 54 (36.24) | 23 (28.40) | 31 (45.59) | ||||
| 5 | 6 (4.03) | 2 (2.47) | 4 (5.88) | ||||
|
| |||||||
| Bethesda classification | <0.001 | ||||||
| I | 13 (8.72) | 11 (13.58) | 2 (2.94) | 82 (82.83) | 13 (26) | ||
| II | 82 (55.03) | 56 (69.14) | 26 (38.24) | ||||
| III | 12 (8.05) | 4 (4.94) | 8 (11.76) | 5 (5.05) | 7 (14) | 0.001 | |
| IV | 11 (7.38) | 7 (8.64) | 4 (5.88) | 9 (9.09) | 2 (4) | 0.687 | |
| V | 27 (18.12) | 3 (3.70) | 24 (35.29) | 3 (3.03) | 24 (48) | <0.001 | |
| VI | 4 (2.68) | 0 | 4 (5.88) | 0 | 4 (8) | ||
|
| |||||||
| Dimensions | |||||||
| CC | 2.67 (1.74-3.80) | 3.09 (1.88-4.11) | 2.14 (1.63-3.51) | 0.008 | 3.06 ± 1.39 | 2.49 ± 1.20 | 0.016 |
| W | 1.94 (1.34-2.98) | 2.29 (1.51-3.20) | 1.66 (1.16-2.33) | 0.008 | 2.34 ± 1.20 | 1.88 ± 0.98 | 0.023 |
| AP | 1.61 (1.06-2.46) | 1.80 (1.19-2.69) | 1.44 (1.00-2.01) | 0.100 | 1.86 ± 0.95 | 1.66 ± 0.87 | 0.215 |
Table 2.
Clinical features associated with malignant thyroid nodules at surgical pathology (n = 149)
| CORRECTED | ORIGINAL | ||||||
|---|---|---|---|---|---|---|---|
|
|
|
||||||
| cOR (95% CI) | p | aOR (95% CI) | p | aOR | 95% CI | p-value | |
| Age (years) | 0.99 (0.96-1.01) | 0.311 | |||||
| <30 | reference | - | reference | - | (reference) | - | - |
| 30-39 | 1.00 (0.31-3.23) | >0.999 | 1.60 (0.39-6.96) | 0.516 | 0.2823 | 0.0402 to 1.9818 | 0.203 |
| 40-49 | 0.74 (0.22-2.40) | 0.616 | 0.86 (0.20-3.82) | 0.845 | 0.4061 | 0.0612 to 2.6961 | 0.351 |
| 50-59 | 0.51 (0.15-1.66) | 0.264 | 0.53 (0.11-2.54) | 0.419 | 0.4125 | 0.0606 to 2.8058 | 0.365 |
| 60-69 | 0.72 (0.21-2.40) | 0.595 | 0.40 (0.08-1.91) | 0.253 | 0.1135 | 0.0146 to 0.8849 | 0.038 |
| ≥70 | 0.44 (0.02-5.53) | 0.538 | 0.23 (0.00-5.34) | 0.413 | 0.1076 | 0.0009 to 12.5138 | 0.358 |
|
| |||||||
| Sex | |||||||
| Female | reference | - | reference | - | |||
| Male | 0.60 (0.21-1.56) | 0.308 | 0.29 (0.07-1.05) | 0.059 | 0.6446 | 0.1113 to 3.7339 | 0.624 |
|
| |||||||
| Composition | |||||||
| Mixed | reference | - | reference | - | |||
| Solid | 3.62 (1.79-7.61) | <0.001 | 2.14 (0.90-5.26) | 0.084 | 4.9122 | 1.3257 to 18.2011 | 0.017 |
|
| |||||||
| Echogenicity | |||||||
| Hyperechoic or isoechoic | reference | - | reference | - | reference | - | - |
| Hypoechoic | 1.15 (0.53-2.50) | 0.722 | 1.21 (0.49-3.08) | 0.676 | 1.9757 | 0.6069 to 6.4319 | 0.258 |
| Markedly hypoechoic | 2.75 (1.19-6.54) | 0.019 | 3.48 (1.16-11.47) | 0.026 | 3.6708 | 0.8463 to 15.9214 | 0.082 |
|
| |||||||
| Margins | |||||||
| Well-circumscribed | reference | - | reference | - | reference | - | - |
| Microlobulated | 0.71 (0.30-1.64) | 0.425 | 0.77 (0.29-1.96) | 0.582 | 2.0423 | 0.5823 to 7.1637 | 0.265 |
| Irregular | 1.65 (0.78-3.51) | 0.190 | 0.63 (0.23-1.67) | 0.361 | 1.6792 | 0.4940 to 5.7073 | 0.406 |
|
| |||||||
| Calcifications | |||||||
| None | reference | - | |||||
| Microcalcifications | 2.48 (0.91-7.14) | 0.081 | |||||
| Macrocalcifications | 0.65 (0.30-1.45) | 0.292 | |||||
|
| |||||||
| Shape | |||||||
| Wider than tall | reference | - | |||||
| Taller than wide | 1.80 (0.77-4.33) | 0.178 | |||||
|
| |||||||
| Bethesda classification | |||||||
| I or II | reference | - | reference | - | reference | - | - |
| III | 4.47 (1.36-16.64) | 0.013 | 4.04 (1.07-17.68) | 0.039 | 7.4988 | 1.5572 to 36.1108 | 0.012 |
| IV | 1.42 (0.38-4.84) | 0.586 | 1.78 (0.44-6.88) | 0.405 | 1.9548 | 0.3329 to 11.4788 | 0.458 |
| V | 16.58 (5.56-65.78) | <0.001 | 13.95 (4.11-63.61) | <0.001 | 36.7881 | 8.1908 to 165.2305 | <0.0001 |
| VI | 21.32 (2.17-2859.90) | 0.006 | 17.42 (1.31-2510.29) | 0.028 | - | - | - |
|
| |||||||
| Dimensions | |||||||
| CC | 0.69 (0.53-0.89) | 0.005 | |||||
| W | 0.65 (0.47-0.88) | 0.007 | |||||
| AP | 0.72 (0.49-1.02) | 0.071 | |||||
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