Is thyroid imaging reporting and data system useful as an adult ultrasonographic malignancy risk stratification method in pediatric thyroid nodules?

• Main Authors: Yasemin Durum Polat, Veli Süha Öztürk, Nimet Ersoz, Ahmet Anık, Can Zafer Karaman
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2019-01-01
• Series: Journal of Medical Ultrasound
• Subjects: Imaging; pediatric; thyroid cancer; thyroid nodule; thyroid ultrasound
• Online Access: http://www.jmuonline.org/article.asp?issn=0929-6441;year=2019;volume=27;issue=3;spage=141;epage=145;aulast=Polat
• ISSN: 0929-6441; 2212-1552

Background: Data on thyroid imaging reporting and data system (TI-RADS) generally belong to studies performed in adults. Therefore, we aimed to evaluate the performance and utility of TI-RADS in the pediatric group. Materials and Methods: From January 2015 to 2018, 108 nodules were evaluated in 1028 thyroid ultrasound examinations. Images were retrospectively evaluated by two radiologists with 3 and 7 years of pediatric radiology experience, according to TI-RADS classification. Morphological findings of the detected nodules and their histopathological results were recorded. Histopathological findings and at least 12 months of follow-up imaging were taken as reference. Results: Seventy-one patients were female (67%). The mean age was 11.4 ± 4.7, and the mean nodule size was 7.4 ± 8.3 mm. According to the histopathological assessment and at least 12 months' follow-up with clinical and sonographic stability 100 (95.2%) of the nodules were benign and 5 (4.8%) were malignant. Two nodules, nondiagnostic cytology and 1 nodule were found to be suspicious for malignancy. All malignant nodules were in the TI-RADS 5 category. The majority of benign nodules (79%) were found in low TI-RADS categories. About 80% of the malignant nodules were very hypoechoic and taller than wide in shape, also all malignant nodules had microcalcifications (P = 0.000). The sensitivity of TI-RADS was 100%, specificity was 78.8%, positive predictive value (PPV) was 19.2%, and negative predictive value (NPV) was 100%. Conclusion: According to our study, TI-RADS system can be used to evaluate thyroid nodules in pediatric patients similar to adults.