Diagnostic performance of the 2021 Korean thyroid imaging reporting and data system in pediatric thyroid nodules
- Abstract
- Objectives: To evaluate the diagnostic performance of 2021 K-TIRADS biopsy criteria for detecting malignant thyroid nodules in a pediatric population, making comparisons with 2016 K-TIRADS.
Methods: This retrospective study included pediatric patients with histopathologically confirmed diagnoses. The diagnostic performance of 2021 K-TIRADS was compared with that of 2016 K-TIRADS. Simulation studies were performed by changing biopsy cut-off sizes for K-TIRADS 5 to 1.0 cm (K-TIRADS5-1.0cm) and 0.5 cm (K-TIRADS5-0.5cm), and for K-TIRADS 4 to 1.0 cm (K-TIRADS4-1.0cm) and 1.0-1.5 cm (K-TIRADS4-1.0~1.5cm). Subgroup analysis was performed in small (< 1.5 cm) and large nodules (≥ 1.5 cm).
Results: Two hundred seventy-seven thyroid nodules (54.9% malignant) from 221 pediatric patients were analyzed. All simulated 2021 K-TIRADS showed higher accuracy than 2016 K-TIRADS. Compared with 2021 K-TIRADS5-1.0cm, 2021 K-TIRADS5-0.5cm showed lower specificity (51.6% vs. 47.9%; p = 0.004) but higher sensitivity (77.2% vs. 90.3%; p < 0.001) and accuracy (62.7% vs. 68.9%; p < 0.001). Compared with 2021 K-TIRADS4-1.0cm, 2021 K-TIRADS4-1.0~1.5cm showed higher specificity (44.9% vs. 47.9%; p = 0.018) without significant difference in other diagnostic measures. Compared with 2016 K-TIRADS, 2021 K-TIRADS (biopsy cut-offs, 0.5 cm for K-TIRADS 5; 1.0-1.5 cm for K-TIRADS 4) showed higher sensitivity (34.0% vs. 67.3%; p < 0.001) while maintaining specificity (89.4% vs. 88.2%; p = 0.790) in small nodules, and higher specificity (5.9% vs. 25.4%; p < 0.001) while maintaining sensitivity (100% vs. 98.7%; p = 0.132) in large nodules.
Conclusions: In pediatric patients, 2021 K-TIRADS showed superior diagnostic accuracy to 2016 K-TIRADS, especially with a biopsy cut-off of 0.5 cm for K-TIRADS 5 and 1.0-1.5 cm for K-TIRADS 4.
- Author(s)
- Pyeong Hwa Kim; Hee Mang Yoon; Jung Hwan Baek; Sae Rom Chung; Young Jun Choi; Jeong Hyun Lee; Jin Seong Lee; Ah Young Jung; Young Ah Cho; Boram Bak; Dong Gyu Na
- Issued Date
- 2023
- Type
- Article
- Keyword
- Biopsy; Pediatrics; Thyroid; Thyroid neoplasm; Ultrasonography
- DOI
- 10.1007/s00330-022-09037-2
- URI
- https://oak.ulsan.ac.kr/handle/2021.oak/17461
- Publisher
- EUROPEAN RADIOLOGY
- Language
- 영어
- ISSN
- 0938-7994
- Citation Volume
- 33
- Citation Number
- 1
- Citation Start Page
- 172
- Citation End Page
- 180
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- Medicine > Nursing
- 공개 및 라이선스
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