Insights into Ultrasound Features and Risk Stratification Systems in Pediatric Patients with Thyroid Nodules

Overview

Journal J Imaging

Publisher MDPI

Specialty Radiology

Date 2024 Aug 28

PMID 39194977

Authors

Carla Gambale

Jose Vicente Rocha

Alessandro Prete

Elisa Minaldi

Rossella Elisei

Antonio Matrone

Affiliations

Soon will be listed here.

Abstract

Thyroid nodules in pediatric patients are less common than in adults but show a higher malignancy rate. Accordingly, the management of thyroid nodules in pediatric patients is more complex the younger the patient is, needing careful evaluation by physicians. In adult patients, specific ultrasound (US) features have been associated with an increased risk of malignancy (ROM) in thyroid nodules. Moreover, several US risk stratification systems (RSSs) combining the US features of the nodule were built to define the ROM. RSSs are developed for the adult population and their use has not been fully validated in pediatric patients. This study aimed to evaluate the available data about US features of thyroid nodules in pediatric patients and to provide a summary of the evidence regarding the performance of RSS in predicting malignancy. Moreover, insights into the management of thyroid nodules in pediatric patients will be provided.

Citing Articles

Can ACR TI-RADS predict the malignant risk of medullary thyroid cancer?.

Zhang Y, Ye B, Wang H, Liu B, Liu Y, Wei Q J Clin Transl Endocrinol. 2025; 39():100380.

PMID: 39811784 PMC: 11732179. DOI: 10.1016/j.jcte.2024.100380.

References

Dean D, Gharib H . Epidemiology of thyroid nodules. Best Pract Res Clin Endocrinol Metab. 2008; 22(6):901-11. DOI: 10.1016/j.beem.2008.09.019. View

Francis G, Waguespack S, Bauer A, Angelos P, Benvenga S, Cerutti J . Management Guidelines for Children with Thyroid Nodules and Differentiated Thyroid Cancer. Thyroid. 2015; 25(7):716-59. PMC: 4854274. DOI: 10.1089/thy.2014.0460. View

Polat Y, Ozturk V, Ersoz N, Anik A, Karaman C . Is Thyroid Imaging Reporting and Data System Useful as an Adult Ultrasonographic Malignancy Risk Stratification Method ın Pediatric Thyroid Nodules?. J Med Ultrasound. 2019; 27(3):141-145. PMC: 6905278. DOI: 10.4103/JMU.JMU_35_19. View

Goldfarb M, Gondek S, Sanchez Y, Lew J . Clinic-based ultrasound can predict malignancy in pediatric thyroid nodules. Thyroid. 2012; 22(8):827-31. DOI: 10.1089/thy.2011.0494. View

Castellana M, Castellana C, Treglia G, Giorgino F, Giovanella L, Russ G . Performance of Five Ultrasound Risk Stratification Systems in Selecting Thyroid Nodules for FNA. J Clin Endocrinol Metab. 2019; 105(5). DOI: 10.1210/clinem/dgz170. View

Lim-Dunham J, Toslak I, Alsabban K, Aziz A, Martin B, Okur G . Ultrasound risk stratification for malignancy using the 2015 American Thyroid Association Management Guidelines for Children with Thyroid Nodules and Differentiated Thyroid Cancer. Pediatr Radiol. 2017; 47(4):429-436. DOI: 10.1007/s00247-017-3780-6. View

Cimbek E, Polat R, Sonmez B, Beyhun N, Dinc H, Saruhan H . Clinical, sonographical, and pathological findings of pediatric thyroid nodules. Eur J Pediatr. 2021; 180(9):2823-2829. DOI: 10.1007/s00431-021-04032-z. View

Lyshchik A, Drozd V, Demidchik Y, Reiners C . Diagnosis of thyroid cancer in children: value of gray-scale and power doppler US. Radiology. 2005; 235(2):604-13. DOI: 10.1148/radiol.2352031942. View

Kim P, Yoon H, Baek J, Chung S, Choi Y, Lee J . Diagnostic performance of the 2021 Korean thyroid imaging reporting and data system in pediatric thyroid nodules. Eur Radiol. 2022; 33(1):172-180. DOI: 10.1007/s00330-022-09037-2. View

10.

Tuli G, Munarin J, Scollo M, Quaglino F, de Sanctis L . Evaluation of the efficacy of EU-TIRADS and ACR-TIRADS in risk stratification of pediatric patients with thyroid nodules. Front Endocrinol (Lausanne). 2022; 13:1041464. PMC: 9723319. DOI: 10.3389/fendo.2022.1041464. View

11.

Yu J, Cui Y, Fu C, Ma X, Si C, Huang Y . Comparison of ultrasound risk stratification systems for pediatric thyroid nodules. Front Endocrinol (Lausanne). 2024; 15:1350123. PMC: 10989271. DOI: 10.3389/fendo.2024.1350123. View

12.

Matrone A, Gambale C, Biagini M, Prete A, Vitti P, Elisei R . Ultrasound features and risk stratification systems to identify medullary thyroid carcinoma. Eur J Endocrinol. 2021; 185(2):193-200. DOI: 10.1530/EJE-21-0313. View

13.

Corrias A, Cassio A, Weber G, Mussa A, Wasniewska M, Rapa A . Thyroid nodules and cancer in children and adolescents affected by autoimmune thyroiditis. Arch Pediatr Adolesc Med. 2008; 162(6):526-31. DOI: 10.1001/archpedi.162.6.526. View

14.

Lebbink C, Links T, Czarniecka A, Dias R, Elisei R, Izatt L . 2022 European Thyroid Association Guidelines for the management of pediatric thyroid nodules and differentiated thyroid carcinoma. Eur Thyroid J. 2022; 11(6). PMC: 9716393. DOI: 10.1530/ETJ-22-0146. View

15.

Gupta A, Ly S, Castroneves L, Frates M, Benson C, Feldman H . A standardized assessment of thyroid nodules in children confirms higher cancer prevalence than in adults. J Clin Endocrinol Metab. 2013; 98(8):3238-45. PMC: 3733863. DOI: 10.1210/jc.2013-1796. View

16.

Richman D, Benson C, Doubilet P, Peters H, Huang S, Asch E . Thyroid Nodules in Pediatric Patients: Sonographic Characteristics and Likelihood of Cancer. Radiology. 2018; 288(2):591-599. PMC: 6369930. DOI: 10.1148/radiol.2018171170. View

17.

Rago T, Cantisani V, Ianni F, Chiovato L, Garberoglio R, Durante C . Thyroid ultrasonography reporting: consensus of Italian Thyroid Association (AIT), Italian Society of Endocrinology (SIE), Italian Society of Ultrasonography in Medicine and Biology (SIUMB) and Ultrasound Chapter of Italian Society of Medical.... J Endocrinol Invest. 2018; 41(12):1435-1443. DOI: 10.1007/s40618-018-0935-8. View

18.

Koltin D, OGorman C, Murphy A, Ngan B, Daneman A, Navarro O . Pediatric thyroid nodules: ultrasonographic characteristics and inter-observer variability in prediction of malignancy. J Pediatr Endocrinol Metab. 2016; 29(7):789-94. DOI: 10.1515/jpem-2015-0242. View

19.

Kim P, Yoon H, Hwang J, Lee J, Jung A, Cho Y . Diagnostic performance of adult-based ATA and ACR-TIRADS ultrasound risk stratification systems in pediatric thyroid nodules: a systematic review and meta-analysis. Eur Radiol. 2021; 31(10):7450-7463. DOI: 10.1007/s00330-021-07908-8. View

20.

Davies L, Welch H . Increasing incidence of thyroid cancer in the United States, 1973-2002. JAMA. 2006; 295(18):2164-7. DOI: 10.1001/jama.295.18.2164. View