Assessment of American College of Radiology Thyroid Imaging Reporting                    and Data System (TI-RADS) for Pediatric Thyroid Nodules

Richman, Danielle M; Benson, Carol B.; Doubilet, Peter M.; Wassner, Ari J.; Asch, Elizabeth; Cherella, Christine E; Smith, Jessica R.; Frates, Mary C.

doi:10.1148/radiol.2019191326

Cited by 71 publications

(59 citation statements)

References 17 publications

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“…A total of 143 FNA samples from 128 patients were identified, with a mean age of 14.9 years (range [7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22] 6%) were Bethesda IV, 5 (3.5%) were Bethesda V, and 4 (2.8%) were Bethesda VI. Of the nodules considered Bethesda I by FNA, 13 (48%) were surgically resected and malignancy was identified in 3 (23%).…”

Section: Resultsmentioning

confidence: 99%

“…TI-RADS has not yet been adopted for the management of pediatric thyroid nodules. A recent study demonstrated that TI-RADS does not perform optimally in the pediatric population as a significant portion of patients would have a delay in diagnosis of carcinoma [15]. Nevertheless, the use of TI-RADS scores outside of the FNA decision-making algorithm may still be of use in differentiating benign from malignant nodules [16].…”

Section: Introductionmentioning

confidence: 99%

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Improving Malignancy Prediction in AUS/FLUS Pediatric Thyroid Nodules with the Aid of Ultrasound

Arora¹,

Trout²,

Chuang³

2020

Horm Res Paediatr

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Introduction: The standard workup of thyroid nodules concerning for malignancy includes fine-needle aspiration (FNA). In 2015, the American Thyroid Association (ATA) guidelines for the management of pediatric thyroid nodules recommended that all nodules with a Bethesda III cytology undergo surgical resection. Objectives: To correlate a Bethesda III cytology with histologic and clinical outcomes to determine the relevance of the ATA recommendations, and to evaluate whether Thyroid Imaging Reporting and Data System (TI-RADS) scoring could identify Bethesda III nodules at a lower risk of malignancy. Methods: A retrospective chart review of patients who had undergone thyroid nodule FNA from 2008 to 2018 was performed. Malignancy rates were determined for each Bethesda category. The reference standard was histopathology or 2-year follow-up of imaging outcomes for nonoperative cases. Ultrasound exams of Bethesda III nodules were reviewed and TI-RADS scores assigned. Results: A total of 143 FNA samples from 128 patients were identified. The mean age was 14.9 years (range 7–22). Twenty-two (15%) of the FNA samples were Bethesda III; the malignancy rate was 38%. A TI-RADS score was assigned in 20 of the 22 Bethesda III nodules. ROC analysis found an optimal cut-off for malignancy prediction of ≥7 points (risk category TR5). The negative predictive value was 85.7% (95% CI 35.9–99.6) and the positive predictive value was 83.3% (95% CI 57.2–98.2). Conclusion: Although, at baseline, thyroid nodules with a Bethesda III classification carry a moderate risk of malignancy in the pediatric population, TI-RADS scoring can identify nodules with a lower risk within this group. If validated by larger studies, this can inform decision making and reduce unneeded surgery.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Improving Malignancy Prediction in AUS/FLUS Pediatric Thyroid Nodules with the Aid of Ultrasound

Arora¹,

Trout²,

Chuang³

2020

Horm Res Paediatr

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“…It is essential that an experienced thyroid radiologist performs the ultrasound. Reports upon the use of the ACR TIRADS classification as reporting system in children show contradictory re-Eur Thyroid J 2020;9:234-242 DOI: 10.1159/000508872 sults about its adequacy in children [32,33], and no studies exist that evaluate this classification system in children with a germline PTEN mutation. For this reason, no recommendation for using this reporting system can be made.…”

Section: Discussionmentioning

confidence: 99%

Recommendations on Surveillance for Differentiated Thyroid Carcinoma in Children with PTEN Hamartoma Tumor Syndrome

Jonker¹,

Lebbink²,

Jongmans³

et al. 2020

Eur Thyroid J

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Background: PTEN hamartoma tumor syndrome (PHTS) represents a group of syndromes caused by a mutation in the PTEN gene. Children with a germline PTEN mutation have an increased risk of developing differentiated thyroid carcinoma (DTC). Several guidelines have focused on thyroid surveillance in these children, but studies substantiating these recommendations are lacking. Objective: The present study intends to provide the available evidence for a thyroid carcinoma surveillance program in children with PHTS. Methods: An extensive literature search was performed to identify all studies on DTC in pediatric PHTS patients. Two pediatric cases are presented to illustrate the pros and cons of thyroid carcinoma surveillance. Recommendations for other patient groups at risk for DTC were evaluated. Consensus within the study team on rec-This article is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND) (http://www.karger.com/Services/OpenAccessLicense). Usage and distribution for commercial purposes as well as any distribution of modified material requires written permission.

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“…Ultrasonography is the primary imaging test used to detect thyroid nodules, but it has some limitations in showing the relationship of the tumor to the surrounding structures and in identifying lymph node metastasis (4,5). Fine-needle aspiration is an invasive examination, and one-third of the results are inconclusive (3).…”

Section: Introductionmentioning

confidence: 99%

Dual-source dual-energy computed tomography-derived quantitative parameters combined with machine learning for the differential diagnosis of benign and malignant thyroid nodules

Jiang¹,

Liu²,

Long³

et al. 2022

Quant Imaging Med Surg

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Background: This study aimed to investigate the ability of quantitative parameter-derived dual-source dual-energy computed tomography (DS-DECT) combined with machine learning to distinguish between benign and malignant thyroid nodules.Methods: Patients with thyroid nodules and pathological surgical results who underwent preoperative DS-DECT were selected. Quantitative parameter-derived DS-DECT was applied to classify benign and malignant nodules. Then, machine learning and binary logistic regression analysis models were constructed using the DS-DECT quantitative parameters to distinguish between benign and malignant nodules. The receiver operating characteristic curve was used to assess the diagnostic performance. The DeLong test was used to compare the diagnostic efficacy. Results: One hundred and thirty patients with 139 confirmed thyroid nodules were involved in the study. The malignant group had a significantly higher iodine concentration nodule (arterial phase) (P=0.001), normalized iodine concentration (arterial phase) (P=0.002), iodine concentration difference (P<0.001), spectral curve slope (nonenhancement) (P=0.007), spectral curve slope (arterial phase) (P=0.001), effective atomic number (nonenhancement) (P<0.001), and effective atomic number (arterial phase) (P=0.039) than the benign group. The binary logistic regression analysis model had an AUC (area under the curve) of 0.76, a sensitivity of 0.821, and a specificity of 0.667. The machine learning model had an AUC of 0.86, a sensitivity of 0.822, specificity of 0.791 in the training cohort, an AUC of 0.84, a sensitivity of 0.727, and specificity of 0.750 in the testing cohort. Conclusions: Multiple quantitative parameters of DS-DECT combined with machine learning could differentiate between benign and malignant thyroid nodules.

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Assessment of American College of Radiology Thyroid Imaging Reporting and Data System (TI-RADS) for Pediatric Thyroid Nodules

Cited by 71 publications

References 17 publications

Improving Malignancy Prediction in AUS/FLUS Pediatric Thyroid Nodules with the Aid of Ultrasound

Improving Malignancy Prediction in AUS/FLUS Pediatric Thyroid Nodules with the Aid of Ultrasound

Recommendations on Surveillance for Differentiated Thyroid Carcinoma in Children with PTEN Hamartoma Tumor Syndrome

Dual-source dual-energy computed tomography-derived quantitative parameters combined with machine learning for the differential diagnosis of benign and malignant thyroid nodules

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