Background: The introduction of endovascular thrombectomy dramatically changed acute stroke management and became the standard treatment. Balloon guide catheters provide flow arrest during the clot retrieval process and have several advantages.This study aimed to compare balloon guide catheters (BGCs) versus non-balloon guide catheters (NBGCs) as a part of a combined treatment modality in patients presenting with acute ischemic stroke. Methods: This retrospective study included n = 65 patients who underwent a combined endovascular stroke treatment for distal internal carotid artery (ICA) occlusion. Patients underwent aspiration and stent retriever thrombectomy with the use of BGCs (Group 1, n = 27) or NBGCs (Group 2, n = 38). Results: The groups were compared for outcomes: the National Institutes of Health Stroke Scale (NIHSSS) score change, successful recanalization, good functional outcome at three months, and in-hospital mortality. Conclusion: The two groups didn’t differ in terms of the NIHSS score change compared to baseline (p > 0.05). Moreover, there were no significant differences between the two groups in terms of the successful recanalization rate, three-month favorable functional outcome rate, and in-hospital mortality (p = 0.292, p = 0.952, p = 0.178), respectively. Further prospective studies with a larger number of patients and better methodology are warranted.

Background/Objectives: Guidelines for the risk stratification of thyroid nodules are based on certain well-recognized sonographic features of nodules. However, significant variations in reported sensitivity and specificity values are observed due to the overlap of imaging characteristics between benign and malignant nodules. Additionally, differences in ultrasound (US) equipment and the varying experience levels of radiologists performing the imaging procedures contribute to these discrepancies. Inevitably, there are also interobserver differences. The aim of this study was to investigate interobserver agreement on these criteria using the international thyroid imaging reporting and data system (I-TIRADS) thyroid evaluation framework, independently assessed by three residents and one consultant. Methods: We included 393 patients who underwent ultrasound-guided fine needle aspiration biopsy (FNAB) within four months. In each case, longitudinal and transverse video images of the thyroid gland, neck chain, and biopsied nodules were recorded. The evaluations of the parameters defined in the I-TIRADS dictionary were then performed by a radiologist with 15 years of experience and radiology assistants with 3, 3, and 2 years of experience, respectively, blinded to the images, pathology data, and patient demographics. The parameters evaluated included composition, echogenicity, margin, direction of growth, calcification, extension beyond the thyroid, and lymph node. An interobserver comparison between the US lexicon classifications of thyroid nodules was then performed. Results: The results of our study showed that the highest level of consensus was observed in the ‘mixed predominantly cystic’ classification, indicating a solid consistency between the assessors (κ = 0.729). Conversely, the subcategories ‘Solid’, ‘Mixed Predominantly Solid’ and ‘Spongiform’ showed moderate agreement, while the “Pure Cyst” subcategory exhibited the lowest level of agreement among the assessors (κ = 0.292). Agreement among the three radiology assistants was strong concerning the evaluation of nodule composition, growth direction, and lymph node assessment. In contrast, a moderate level of consensus was noted regarding the assessment of extrathyroidal extension, margins, and echogenicity. Notably, the parameter exhibiting moderate agreement across all readers was the presence of echogenic foci or calcifications. Conclusions: the reproducibility observed in the parameters defined within the lexicon supports its potential to enhance consistency and interobserver agreement in thyroid nodule assessment.

Background/Objectives: Standardizing thyroid nodule assessment remains a major challenge in clinical practice and radiology education. Traditional categorical risk stratification systems (RSSs) often yield high interobserver variability, particularly among trainees. This study evaluated the reproducibility, educational utility, and experience-dependent performance of the parameter-based International Thyroid Imaging Reporting and Data System (I-TIRADS) lexicon compared to established categorical RSSs (ACR, EU, and K-TIRADS). Methods: In this prospective validation study, 105 thyroid nodules stratified across Bethesda categories were evaluated by seven radiologists: one senior expert (as reference standard) and six residents categorized into three distinct experience levels (Junior, Intermediate, Senior). To simulate real-time clinical practice and eliminate 2D static image bias, comprehensive dynamic video clips were utilized for all cases. Interobserver agreement and intergroup consistency were quantified using Fleiss’ and Cohen’s kappa (κ) statistics. Results: Parameter-based I-TIRADS descriptors—specifically composition (κ = 0.510) and direction of growth (κ = 0.498)—demonstrated significantly higher overall reliability compared to final categorical RSS classifications (ACR: κ = 0.220, EU: κ = 0.215, K-TIRADS: κ = 0.196). Crucially, the reproducibility advantage of the I-TIRADS lexicon became markedly more pronounced with advancing clinical experience: senior observers achieved substantial to near-perfect consensus for core descriptors (up to κ = 0.826), whereas agreement for traditional RSS categories remained limited. I-TIRADS facilitated a steeper learning curve, allowing even junior trainees to achieve reliable consensus on objective sonographic parameters. Conclusions: The parameter-based I-TIRADS provides superior interobserver consistency compared to traditional categorical RSSs by reducing subjective evaluative drift, accelerating the radiologic learning curve, and offering a highly reproducible framework for both clinical practice and residency education.