Smitthimedhin Anilawan,  Krishnamurthy Ganesh,  Sridharan Anush,  Poznick Laura,  Durand Rachelle,  Whitaker Jayme,  Escobar Fernando,  Bauer Andrew,  Cahill Anne Marie

Final Pr. ID: Paper #: 140

Contrast-enhanced ultrasound (CEUS) and shear wave elastography (SWE) have been widely studied in adult thyroid disease. However, evaluation of thyroid nodules using these tools in pediatric patients has yet to be published.
We aim to evaluate the feasibility and safety of CEUS and SWE for thyroid nodules in children at the time of cytologic biopsy. Read More

Authors:  Smitthimedhin Anilawan , Krishnamurthy Ganesh , Sridharan Anush , Poznick Laura , Durand Rachelle , Whitaker Jayme , Escobar Fernando , Bauer Andrew , Cahill Anne Marie

Keywords:  CEUS, Elastography, Thyroid

Marie Eman,  Navallas María,  Gerrie Samantha,  Olkh Juhi,  Elghamudi Taha,  Inarejos Clemente Emilio J,  Navarro Oscar,  Martinez-rios Claudia,  Vali Reza

Final Pr. ID: Poster #: EDU-094

Thyroid cancer is the most prevalent endocrine malignancy in the pediatric population. Accurate diagnosis and staging of thyroid carcinoma demand a multimodality approach, including anatomic imaging with US, CT, and MRI, alongside functional or metabolic nuclear imaging. Novel imaging techniques such as US elastography, contrast-enhanced US (CEUS), superb microvascular imaging (SMI) and dual-source dual-energy thyroid CT have offered non-invasive tools to assess disease status. Furthermore, the emerging field of radiomics/radiogenomics and artificial intelligence is continuously growing, creating models to classify or predict disease behaviour. We provide a comprehensive overview of the essential imaging characteristics of pediatric thyroid carcinoma using conventional and novel imaging techniques. In addition, we illustrate the multimodality, multidisciplinary, and collaborative approach across pediatric radiology and nuclear medicine in pre-operative, post-operative and post-treatment imaging surveillance of cancer thyroid in children. Read More

Authors:  Marie Eman , Navallas María , Gerrie Samantha , Olkh Juhi , Elghamudi Taha , Inarejos Clemente Emilio J , Navarro Oscar , Martinez-rios Claudia , Vali Reza

Keywords:  Thyroid, CEUS, Nodules

Navallas Maria,  Daneman Alan,  Amirabadi Afsaneh,  Wasserman Jonathan

Final Pr. ID: Poster #: SCI-067

To evaluate the diagnostic accuracy of US and the most useful sonographic features for diagnosing metastatic cervical adenopathy in pediatric patients with thyroid carcinoma Read More

Authors:  Navallas Maria , Daneman Alan , Amirabadi Afsaneh , Wasserman Jonathan

Keywords:  Thyroid carcinoma, cervical lymphadenopathy, ultrasound

Castro Coria Maria,  Castrillon Macarena,  Kaplan Julio,  Dardanelli Esteban,  Prati Yanet,  Mackintosh Cecilia,  Orozco Maria,  Dujovne Noelia,  Santa Cruz Carina

Final Pr. ID: Poster #: CR-007

The incidence of thyroid nodules in the pediatric population is low, ranging from approximately 0.5% to 5%. The risk of malignancy is higher than in adults.
ultrasound is considered the “gold standard” for an accurate and reliable evaluation of thyroid nodules, identifying predictors of malignancy.
Epidermoid cysts (EC) can be distinguished from dermoid cysts, and EC are extremely rare with fewer than 20 cases reported, only two of them involved pediatric patients.
Due to the content of keratin and squamous cells, the epidermoid cyst may present a solid ultrasound appearance with echogenic punctiform images that could simulate calcifications, even in the color Doppler examination it could present scintillation artifact. Therefore, cytologic evaluation is essential in the diagnosis, and shows sheets of anucleated squamous cells mixed with few nucleated ones with absence of cellular atypia, granuloma or thyroid epithelial cells Read More

Authors:  Castro Coria Maria , Castrillon Macarena , Kaplan Julio , Dardanelli Esteban , Prati Yanet , Mackintosh Cecilia , Orozco Maria , Dujovne Noelia , Santa Cruz Carina

Keywords:  Thyroid

Sensbach Jessica,  Ghias Adeeba,  Anderson Kelly,  Rooks Veronica

Final Pr. ID: Poster #: CR-025

The thyroglossal duct cyst (TGDC) is the most common congenital malformation in the neck. The Sistrunk procedure is the standard surgical treatment and includes resection of the central hyoid and a cuff tongue base musculature toward the foramen cecum.

We present a 24yr old F with a TGDC complicated by fistulous drainage and multiple surgeries. Imaging was critical for definitive identification of a sinus tract and treatment. She presented initially with a cystic neck lesion treated as a ranula with sublingual then submandibular gland excision. She subsequently presented with spontaneous drainage of saliva from the neck 2 yrs later and underwent Sistrunk procedure. When she presented with persistent salivary draining within 1 week of Sistrunk, there was concern for a persistent thyroglossal duct tract or alternate connection to the oropharynx not visualized despite direct laryngoscopy.

Obturation of the wound was attempted, without success. This novel concept of balloon occlusion pullback fistulogram in the open surgical wound led to discovering a tract extending superiorly toward the tongue base. A 14 Fr Foley catheter was inserted into the draining neck wound, balloon expansion in the cavity. Gentle traction was used to occlude the wound and fill the cavity. Ten mL of Omnipaque 180 contrast was infused through the catheter, outlining the balloon in the subcutaneous cavity and an opacified fistulous tract extending midline toward the tongue base posteriorly.

The otolaryngologist, present during flouroscopic exam, employed a similar technique in the OR with methylene blue diluted with saline. This created a roadmap resulting in a revised Sistrunk procedure, excising all abnormal appearing tissue and tongue base. The procedure was completed under direct laryngoscopy identifying the tongue base tissue that needed to be cored out. Only a few reported cases in the literature used fistulograms to identify TGDCs and determine the extent including associated sinus tracts, none of which described the same novel technique of balloon occlusion pullback within the open wound.

Radiographic demonstration of the thyroglossal tract is useful to indicate the extent and location. We present this novel balloon occlusion pullback fistulogram to provide crucial information about the fistulous tract regarding extent, direction, and relationship with adjoining structures for complicated or recurrent TGDCs. This information is crucial in definitive surgical planning. Read More

Authors:  Sensbach Jessica , Ghias Adeeba , Anderson Kelly , Rooks Veronica

Keywords:  Fluoroscopy, Thyroid, Neck

Martinez-rios Claudia,  Bajno Lydia,  Daneman Alan,  Moineddin Rahim,  Van Der Kaay Danielle Cm,  Wasserman Jonathan

Final Pr. ID: Poster #: EDU-109

High-resolution ultrasonography (US) is a valuable and accessible imaging tool to assess and characterize the thyroid gland in children. Pediatric thyroid nodules are infrequent. However, the incidence of thyroid carcinoma in children is near twice the adult population, where the risk of malignancy is up to 15%. Children also have an increased risk for recurrence (39%) as compared to adults, justifying further work and a more aggressive approach. Prompt recognition of the common and uncommon sonographic features of thyroid cancer in children will allow radiologist to identify this malignancy in early stages of the disease, expediting appropriate treatment improving the standard of patient care. The purpose of this exhibit is to 1. To illustrate the spectrum of sonographic findings of thyroid cancer in a pediatric population. 2. To describe the typical sonographic characteristics of malignant thyroid nodules in children. 3. To identify the uncommon features of pediatric thyroid cancer. 4. To describe an appropriate approach to deal with uncertain diagnosis. Read More

Authors:  Martinez-rios Claudia , Bajno Lydia , Daneman Alan , Moineddin Rahim , Van Der Kaay Danielle Cm , Wasserman Jonathan

Keywords:  Thyroid, cancer, children, ultrasound

Alazraki Adina,  Milla Sarah

Final Pr. ID: Poster #: CR-013

Ectopic thymic tissue may be found in the neck in up to 20% of the general population. Intrathyroidal thymic rest has been described as a rare entity, present in as many as 1% of children. The course of thymic migration parallels the thyroid and parathyroid glands, which explains their similar ectopic locations. While the natural history of these lesions has not been well studied, it is likely that there is involution of thymic rests with age. A few individual case reports have described the imaging features of intrathryoidal thymic rests confirmed by histopathology and flow cytometry. The aim of this case series is to raise awareness of the characteristic sonographic appearance of this entity to the radiology community. Read More

Authors:  Alazraki Adina , Milla Sarah

Keywords:  Thymic rest, TiRAD, Thyroid

Reyes Recasens Magdalena,  Daneman Alan,  Amirabadi Afsaneh,  Wasserman Jonathan,  Martinez-rios Claudia

Final Pr. ID: Poster #: EDU-099

Pediatric thyroid carcinoma (PTC) is associated with higher rates of regional and lung metastases and a greater recurrence rate, though it maintains an excellent overall prognosis. While the diffuse sclerosing variant of PTC (DSV-PTC) is a rare subtype, it is disproportionately observed in the pediatric population. Ultrasound findings of DSV-PTC can include a thyroid nodule or diffuse thyroid enlargement, heterogeneous hypoechogenicity, and diffuse microcalcifications. It often presents with extensive cervical lymph node metastasis and more advanced disease at the time of diagnosis, which is linked to a higher recurrence risk. However, a comprehensive description of the sonographic features of DSV-PTC within a large pediatric cohort is currently lacking. This exhibit aims to address the current knowledge gap by illustrating the spectrum of sonographic findings for DSV-PTC in a pediatric population and describing its common associated imaging features. Read More

Authors:  Reyes Recasens Magdalena , Daneman Alan , Amirabadi Afsaneh , Wasserman Jonathan , Martinez-rios Claudia

Keywords:  Thyroid Carcinoma, Ultrasound, Education

Malak Wassim,  Zhu Jia,  Castro-aragon Ilse,  Setty Bindu

Final Pr. ID: Poster #: EDU-034

Several ultrasound (US) findings are associated with specific thyroid diseases, but in the vast majority of cases, only a few of these findings are seen. The purpose of this poster is to describe the US findings in a variety of clinically/biopsy-proven thyroid diseases and analyze the frequency of such findings in each of the following diseases. Read More

Authors:  Malak Wassim , Zhu Jia , Castro-aragon Ilse , Setty Bindu

Keywords:  Ultrasound, Thyroid, Pediatrics

Hwang Sook Min

Final Pr. ID: Poster #: SCI-037

To evaluate the association between thyroid echogenicity and heterogeneity seen on ultrasonography (US) and thyroid function in pediatric and adolescent populations with autoimmune diffuse thyroid diseases (AITD). Read More

Authors:  Hwang Sook Min

Keywords:  Thyroid, Ultrasound, Adolescent

Biyyam Deepa,  Patel Mittun,  Dance Logan,  Dao Tuan,  Youssfi Mostafa,  Towbin Richard

Final Pr. ID: Poster #: EDU-096

After reviewing the exhibit, participants will be able to recognize suspicious and non-suspicious ultrasound (US) features of pediatric thyroid nodules which will help to triage nodules that need a biopsy. Read More

Authors:  Biyyam Deepa , Patel Mittun , Dance Logan , Dao Tuan , Youssfi Mostafa , Towbin Richard

Keywords:  thyroid, nodules, benign, malignant, biopsy

Mirza Sobia,  Sanchez Ramon,  Ma Grace,  Cielma Tara,  Vaidyanathan Priya

Final Pr. ID: Poster #: EDU-067

Thyroid hemiagenesis (TH) is a rare congenital abnormality associated with a higher incidence of thyroid disease. It is often asymptomatic and an incidental finding. However, TH may present as a palpable thyroid nodule, prompting sonography and thyroid function testing. Ultrasound (US) can differentiate between total absence of the thyroid lobe and severe hypoplasia. It is also useful for guiding fine needle aspiration when warranted. Scintigraphy is useful for determining the presence of ectopic thyroid tissue and to further characterize focal nodular thyroid lesions. Despite their respective roles, imaging findings on both US and scintigraphy can pose diagnostic challenges to the pediatric radiologist.

This educational poster will review the embryology of the thyroid gland, frequency of TH, clinical presentation and associations with additional thyroid anomalies such as malignancy, thyroiditis and abnormal gland function. Imaging features of TH will be reviewed with focus on (US) and scintigraphy.

The goals of this exhibit are:
1. Review the incidence and clinical presentation of pediatric patients with TH
2. Describe the imaging findings and role of ultrasound and scintigraphy in the diagnosis and follow-up of TH
3. Discuss prognosis and outcomes of TH in children Read More

Authors:  Mirza Sobia , Sanchez Ramon , Ma Grace , Cielma Tara , Vaidyanathan Priya

Keywords:  thyroid, hemiagenesis, cancer

Rathore Ashish

Final Pr. ID: Poster #: EDU-109

Congenital hypothyroidism (CH) represents the most frequent neonatal endocrine disorder and remains a key preventable cause of neurodevelopmental delay. Radiologists play a central role in identifying the underlying cause, yet the scintigraphic interpretation of CH can be challenging without a firm grasp of thyroid embryology, physiology, and the biochemical processes governing thyroid hormone synthesis. This educational poster uses data and experience from our large single-centre review of paediatric thyroid scintigraphy - including the largest reported cohort of dual thyroid ectopia - to illustrate how an understanding of thyroid anatomy, embryologic development, and hormone physiology can be directly applied to image interpretation.

We first review the embryologic descent of the thyroid gland from the pharyngeal floor to its final pre-tracheal position, explaining how developmental arrest leads to dysgenesis patterns such as ectopia, hypoplasia, and athyreosis. We then summarise the steps of thyroid hormone synthesis - iodide trapping, organification, coupling, and release - highlighting the roles of NIS, Pendrin, TPO, THOX, and thyroglobulin, and how specific protein defects or inhibitory states (e.g., iodine overload) produce distinctive scintigraphic appearances.

Building on these physiologic principles, we present a structured approach to interpreting thyroid scintigraphy in congenital hypothyroidism, illustrated with representative cases of each aetiological category: thyroid dysgenesis (athyreosis, ectopia, hypoplasia), dyshormonogenesis (trapping and organification defects), and transient hypothyroidism. A practical diagnostic algorithm is proposed that integrates scintigraphic findings with biochemical and ultrasound data, enabling accurate aetiological classification.

The poster also reviews the advantages of thyroid scintigraphy - including its ability to assess functional tissue, distinguish agenesis from ectopia, and identify dual or subclinical foci not visible on ultrasound - emphasising its continuing value in the era of neonatal screening. This educational framework equips radiologists with the embryologic and physiologic context required to interpret thyroid scintigraphy confidently and consistently across the spectrum of congenital hypothyroidism. Read More

Authors:  Rathore Ashish

Keywords:  Thyroid

Retamal Caro Andres,  Pérez-marrero Lizbet,  Horvath Eleonora,  Silva Claudio,  Rojas Paula

Final Pr. ID: Poster #: SCI-088

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. Read More

Authors:  Retamal Caro Andres , Pérez-marrero Lizbet , Horvath Eleonora , Silva Claudio , Rojas Paula

Keywords:  TIRADS, thyroid cancer, thyroid node in children and adolescent, thyroid cancer in children and adolescent, sonographic patterns of thyroid node