Purpose or Case Report: To determine the percentage of malignancy for the different TIRADS categories and the ultrasound patterns in children and adolescents.
To calculate the interobserver variability in the use of TIRADS classification in this group.
Methods & Materials: Retrospective observational study. All pediatric and adolescent patients who underwent to a thyroid fine needle aspiration (FNA) in our institution between 2007 and 2014 were included.
Three blind radiologists evaluated independently the images and classified the ultrasound pattern and TIRADS for each nodule.
The gold standard was the FNA result. This result was correlated with TIRADS and the sonographic patterns.
The risk of malignancy for each TIRADS categories and for different ultrasound pattern was estimated and compared with known adult risk.
Interobserver variability was assessed using kappa coefficient test.
Results: 107 patients and 112 nodules were analyzed. Patients age was between 6 to 21 years old.
The average nodules size was 15 mm. According to FNA results 56% were malignant and 44% benign.
According to TIRADS clasification 3% were TIRADS 2, 6% TIRADS 3, 66% TIRADS 4 and 25% TIRADS 5.
The percentage of malignancy in different TIRADS categories was 0% for TIRADS 2 and 3, 50% for TIRADS 4 and 93% for TIRADS 5. Results were similar to known adult risk, except in TIRADS 3, whose known risk is less than 5%.
The risk of malignancy of each sonographic patterns were concordant with adults results.
The kappa value was 0.85 which indicated high interobserver agreement.
Conclusions: We found good correlation between the percentage of malignancy of different TIRADS categories and sonographic patterns.
According to our results we can suggest that TIRADS classification is applicable in children and adolescents. Our results are similar to adults.
It is important that pediatrics radiologists be aware of TIRADS categories and utrasound patterns to improve the diagnosis of thyroid nodules.