Utility of Ultrasound Surveillance for Thyroid Cancer in Children
Authors' conclusion
In pediatric DTC patients with excellent response to initial therapy, the utility of serial US surveillance is limited by the low risk of SDN and frequent false-positive US findings. In children with indeterminate RTT, SDN occurs in a significant proportion and may be detected by US or by abnormal Tg/TgAb levels.
Study context
- Population
- Pediatric patients (<19 years) with differentiated thyroid cancer (DTC) diagnosed 1998–2022, after thyroidectomy ± radioactive iodine, with excellent or indeterminate 1-year response to therapy (RTT)
- Participants
- 112 patients
- Exposure
- Excellent vs indeterminate 1-year response to therapy
- Excellent RTTn = 61
- Indeterminate RTTn = 51
- Outcome
- Subsequent diagnosis of residual/recurrent structural disease in the neck (SDN), in relation to US and Tg/TgAb findings at 1 year
Main finding
As reported in the abstract
SDN during follow-up · median follow-up 6.4 years (IQR 3.8-8.9)
Excellent RTT
0
events
Indeterminate RTT
17.6%
9 of 51
Observational data: associations, not effects.
Further findings
- False-positive indeterminate or abnormal US finding (excellent RTT)
- 29.5% · 18 of 61
Detection of structural disease in the neck (SDN) (indeterminate RTT)
- SDN detected by US
- 7/9 (77.8%)
- SDN detected by I-123 scan but not US, both with abnormal Tg/TgAb
- 2 (22.2%)
- SDN detectable by Tg/TgAb
- 7/9 (77.8%)
Surveillance US and fine-needle aspiration (FNA)
- Surveillance neck US performed
- 683
- US per patient per year, mean ± SD
- 1.0 ± 0.4
- FNA performed
- 17/112 (15.2%)
- FNA diagnosing SDN
- 6 patients
- FNA without SDN diagnosis
- 11/112 (9.8%)
Original publication
Utility of Ultrasound Surveillance for Thyroid Cancer in Children. Thyroid. Published 31 January 2025. doi:10.
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