Risk Stratification of Pediatric Thyroid Nodules Using Adult Thyroid Nodule Scoring Systems:American Thyroid Association and American College of Radiology Thyroid Imaging Reporting and Data System
Authors' conclusion
ATA and TIRADS have low sensitivity in pediatrics. Lowering the size cut-offs for FNA increases sensitivity to >90%.
Study context
- Population
- Patients aged ≤18 years with thyroid nodules, 2002 to 2022; median age 15 years (range 2–18 years); 71.4% women115 thyroid nodules
- Participants
- 77 patients
- Comparison
- American Thyroid Association (ATA) vs ACR TIRADS risk stratification for fine needle aspiration (FNA) recommendation in pediatric thyroid nodules
- Outcome
- Performance of ATA and TIRADS using adult size cut-offs for FNA
Methodological detailsretrospective review, blinded independent review by 2 radiologists, arbitration by a third radiologist, Nonresected nodules considered benign if size stable and/or repeat FNA again benign
- Retrospective review
- Blinded independent review by 2 radiologists
- Arbitration by a third radiologist
- Nonresected nodules considered benign if size stable and/or repeat FNA again benign
Performance
As reported in the abstract
Performance with adult size cut-offs for FNA
| Test or model | Malignant nodules not recommended for biopsy | Sensitivity | Specificity |
|---|---|---|---|
| ATA | 11 of 32 | 66% | 55% |
| TIRADS | 15 of 32 | 53% | 87% |
Malignant nodules not recommended for biopsy
ATA11 of 32
TIRADS15 of 32
Sensitivity
ATA66%
TIRADS53%
Specificity
ATA55%
TIRADS87%
- Malignancy rate
- 27.8%
Further findings
Optimal size cut-offs for FNA (sensitivity analysis): ATA 2 cm very low, 1 cm low, 0.5 cm intermediate and high risk; TIRADS 3 cm TIRADS-2, 0.8 cm TIRADS-3 and TIRADS-4, 0.5 cm TIRADS-5
Sensitivity
Specificity
Original publication
Risk Stratification of Pediatric Thyroid Nodules Using Adult Thyroid Nodule Scoring Systems:American Thyroid Association and American College of Radiology Thyroid Imaging Reporting and Data System. Endocr Pract. Published 26 June 2026. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →