Exploring the Performance of Ultrasound Risk Stratification Systems in Thyroid Nodules of Pediatric Patients

Neck ultrasound (nUS) is the cornerstone of clinical management of thyroid nodules in pediatric patients, as well as adults. The current study was carried out to explore and compare the diagnostic performance of the main US-based risk stratification systems (RSSs) (i.e., the American College of Radi...

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Autores principales:	Lorenzo Scappaticcio, Maria Ida Maiorino, Sergio Iorio, Giovanni Docimo, Miriam Longo, Anna Grandone, Caterina Luongo, Immacolata Cozzolino, Arnoldo Piccardo, Pierpaolo Trimboli, Emanuele Miraglia Del Giudice, Katherine Esposito, Giuseppe Bellastella
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	pediatric thyroid nodules neck ultrasound Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/be7995a0afab4e26b52538251f062acc
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spelling	oai:doaj.org-article:be7995a0afab4e26b52538251f062acc2021-11-11T15:27:47ZExploring the Performance of Ultrasound Risk Stratification Systems in Thyroid Nodules of Pediatric Patients10.3390/cancers132153042072-6694https://doaj.org/article/be7995a0afab4e26b52538251f062acc2021-10-01T00:00:00Zhttps://www.mdpi.com/2072-6694/13/21/5304https://doaj.org/toc/2072-6694Neck ultrasound (nUS) is the cornerstone of clinical management of thyroid nodules in pediatric patients, as well as adults. The current study was carried out to explore and compare the diagnostic performance of the main US-based risk stratification systems (RSSs) (i.e., the American College of Radiology (ACR), European (EU), Korean (K) TI-RADSs and ATA US RSS criteria) for detecting malignant thyroid lesions in pediatric patients. We conducted a retrospective analysis of consecutive children and adolescents who received a diagnosis of thyroid nodule. We included subjects with age <19 years having thyroid nodules with benign cytology/histology or final histological diagnosis. We excluded subjects with (a) a previous malignancy, (b) a history of radiation exposure, (c) cancer genetic susceptibility syndromes, (d) lymph nodes suspicious for metastases of thyroid cancer at nUS, (e) a family history of thyroid cancer, or (f) cytologically indeterminate nodules without histology and nodules with inadequate cytology. We included 41 nodules in 36 patients with median age 15 years (11–17 years). Of the 41 thyroid nodules, 29 (70.7%) were benign and 12 (29.3%) were malignant. For both ACR TI-RADS and EU-TIRADS, we found a sensitivity of 41.7%. Instead, for both K-TIRADS and ATA US RSS, we found a sensitivity of 50%. The missed malignancy rate for ACR-TIRADS and EU-TIRADS was 58.3%, while that for K-TIRADS and ATA US RSS was 50%. The unnecessary FNA prevalence for ACR TI-RADS and EU-TIRADS was 58.3%, while that for K-TIRADS and ATA US RSS was 76%. Our findings suggest that the four US-based RSSs (i.e., ACR-TIRADS, EU-TIRADS, K-TIRADS, and ATA US RSS) have suboptimal performance in managing pediatric patients with thyroid nodules, with one-half of cancers without indication for FNA according to their recommendations.Lorenzo ScappaticcioMaria Ida MaiorinoSergio IorioGiovanni DocimoMiriam LongoAnna GrandoneCaterina LuongoImmacolata CozzolinoArnoldo PiccardoPierpaolo TrimboliEmanuele Miraglia Del GiudiceKatherine EspositoGiuseppe BellastellaMDPI AGarticlepediatric thyroid nodulesneck ultrasoundNeoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENCancers, Vol 13, Iss 5304, p 5304 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	pediatric thyroid nodules neck ultrasound Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	pediatric thyroid nodules neck ultrasound Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Lorenzo Scappaticcio Maria Ida Maiorino Sergio Iorio Giovanni Docimo Miriam Longo Anna Grandone Caterina Luongo Immacolata Cozzolino Arnoldo Piccardo Pierpaolo Trimboli Emanuele Miraglia Del Giudice Katherine Esposito Giuseppe Bellastella Exploring the Performance of Ultrasound Risk Stratification Systems in Thyroid Nodules of Pediatric Patients
description	Neck ultrasound (nUS) is the cornerstone of clinical management of thyroid nodules in pediatric patients, as well as adults. The current study was carried out to explore and compare the diagnostic performance of the main US-based risk stratification systems (RSSs) (i.e., the American College of Radiology (ACR), European (EU), Korean (K) TI-RADSs and ATA US RSS criteria) for detecting malignant thyroid lesions in pediatric patients. We conducted a retrospective analysis of consecutive children and adolescents who received a diagnosis of thyroid nodule. We included subjects with age <19 years having thyroid nodules with benign cytology/histology or final histological diagnosis. We excluded subjects with (a) a previous malignancy, (b) a history of radiation exposure, (c) cancer genetic susceptibility syndromes, (d) lymph nodes suspicious for metastases of thyroid cancer at nUS, (e) a family history of thyroid cancer, or (f) cytologically indeterminate nodules without histology and nodules with inadequate cytology. We included 41 nodules in 36 patients with median age 15 years (11–17 years). Of the 41 thyroid nodules, 29 (70.7%) were benign and 12 (29.3%) were malignant. For both ACR TI-RADS and EU-TIRADS, we found a sensitivity of 41.7%. Instead, for both K-TIRADS and ATA US RSS, we found a sensitivity of 50%. The missed malignancy rate for ACR-TIRADS and EU-TIRADS was 58.3%, while that for K-TIRADS and ATA US RSS was 50%. The unnecessary FNA prevalence for ACR TI-RADS and EU-TIRADS was 58.3%, while that for K-TIRADS and ATA US RSS was 76%. Our findings suggest that the four US-based RSSs (i.e., ACR-TIRADS, EU-TIRADS, K-TIRADS, and ATA US RSS) have suboptimal performance in managing pediatric patients with thyroid nodules, with one-half of cancers without indication for FNA according to their recommendations.
format	article
author	Lorenzo Scappaticcio Maria Ida Maiorino Sergio Iorio Giovanni Docimo Miriam Longo Anna Grandone Caterina Luongo Immacolata Cozzolino Arnoldo Piccardo Pierpaolo Trimboli Emanuele Miraglia Del Giudice Katherine Esposito Giuseppe Bellastella
author_facet	Lorenzo Scappaticcio Maria Ida Maiorino Sergio Iorio Giovanni Docimo Miriam Longo Anna Grandone Caterina Luongo Immacolata Cozzolino Arnoldo Piccardo Pierpaolo Trimboli Emanuele Miraglia Del Giudice Katherine Esposito Giuseppe Bellastella
author_sort	Lorenzo Scappaticcio
title	Exploring the Performance of Ultrasound Risk Stratification Systems in Thyroid Nodules of Pediatric Patients
title_short	Exploring the Performance of Ultrasound Risk Stratification Systems in Thyroid Nodules of Pediatric Patients
title_full	Exploring the Performance of Ultrasound Risk Stratification Systems in Thyroid Nodules of Pediatric Patients
title_fullStr	Exploring the Performance of Ultrasound Risk Stratification Systems in Thyroid Nodules of Pediatric Patients
title_full_unstemmed	Exploring the Performance of Ultrasound Risk Stratification Systems in Thyroid Nodules of Pediatric Patients
title_sort	exploring the performance of ultrasound risk stratification systems in thyroid nodules of pediatric patients
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/be7995a0afab4e26b52538251f062acc
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Exploring the Performance of Ultrasound Risk Stratification Systems in Thyroid Nodules of Pediatric Patients

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