ECEESPE2025 Oral Communications Oral Communications 11: Thyroid Part 1 (6 abstracts)
Evaluation of pediatric thyroid nodules with K-TIRADS, ACR-TIRADS, and clinical risk factors
Da Hye Lee 1 , Young Ah Lee 2,3 , Yeon Jin Cho 4,5 , Jae-Kyung Won 6,7 , Seul Bi Lee 5 , Young Hun Choi 4,5 , Kyeong Cheon Jung 6,7 , Young Joo Park 8,9 , Yun Jeong Lee 2,3 & Choong Ho Shin 2,3
1Chung-Ang University Hospital, Pediatrics, Seoul, South Korea; 2Seoul National University Children’s Hospital, Pediatrics, Seoul, South Korea; 3Seoul National University College of Medicine, Pediatrics, Seoul, South Korea; 4Seoul National University College of Medicine, Radiology, Seoul, South Korea; 5Seoul National University Hospital, Radiology, Seoul, South Korea; 6Seoul National University College of Medicine, Pathology, Seoul, South Korea; 7Seoul National University Hospital, Pathology, Seoul, South Korea; 8Seoul National University College of Medicine, Internal Medicine, Seoul, South Korea; 9Graduate School of Convergence Science and Technology, Molecular Medicine and Biopharmaceutical Siences, Seoul, South Korea
JOINT654
Background: A pediatric-specific biopsy cutoff for the Thyroid Imaging Reporting and Data System (TIRADS) is lacking.
Purpose: We investigated the utility of repeat biopsy by analyzing the initial and follow-up TIRADS and biopsy results. We analyzed a pediatric-specific biopsy cutoff considering clinical risk factors using the 2021 Korean (K) and American College of Radiology (ACR) TIRADS.
Methods: Pediatric patients who underwent thyroid nodule biopsy at Seoul National University Hospital between January 2010 and December 2021 were analyzed retrospectively. The diagnostic performance of TIRADS considering risk factors such as Hashimoto’s thyroiditis, previous radiotherapy, a family history of thyroid cancer, or hereditary tumor syndromes was estimated.
Results: A total of 200 patients (median age, 16 years; 17 children<10 years and 183 adolescents 10–19 years; 153 females; 92 with risk factors) with 223 nodules (142 malignant nodules [64% of total; 86% of 166 resected nodules]) were analyzed. Repeat biopsies due to large size, interval growth, or TIRADS 4–5 category revealed that 6/21 (29%) nodules categorized as benign on initial biopsy were postoperative malignant. Compared to the current guideline, applying a modified pediatric-specific biopsy cutoff for both K-TIRADS and ACR-TIRADS (0.5 cm/1.5 cm for TIRADS 4 with/without risk factors and 0.5 cm for all TIRADS 5) improved sensitivity (85% vs. 78% for K-TIRADS, 84% vs. 60% for ACR-TIRADS, both P<.005), missed malignancy rate (33% vs. 39%, 30% vs. 46%, both P<.05), and accuracy (74% vs. 71%, 77% vs. 67%, P=.30 and.002).
Conclusion: For pediatric patients, especially adolescents, with either TIRADS 4 nodules with risk factors or TIRADS 5 nodules, the cutoff size for biopsy needs to be lowered to 0.5 cm. Repeat biopsy is required if clinical and ultrasound findings are discordant, even if the initial biopsy indicates a benign.
Volume 110
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Endocrine Abstracts
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