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Diagnostic Accuracy of Indeterminate Thyroid Nodules

Pediatric thyroid cancers represent 2% of all malignancies in patients under 15 years of age. In children and adolescents, the risk of malignancy in a thyroid nodule is much higher than adults, and ranges from 20-50%. However, developments in the evaluation and risk stratification of thyroid nodules in adults have been inconsistently adapted in the pediatric setting. The American Thyroid Association (ATA) currently recommends biopsy of pediatric nodules ≥1 cm in size as a single component. However, recent analyses of the adult Thyroid Imaging Reporting and Data System (TI-RADS) in pediatric patients has suggested that the system could be used to evaluate pediatric thyroid nodules with several refinements, including lowering the size criteria for biopsy of concerning nodules. While inconsistently utilized in the pediatric setting, molecular testing of thyroid nodules with indeterminate cytology by fine-needle aspiration biopsy may similarly improve prognostication of nodule behavior. Making an accurate pre-operative diagnosis is important to improving surgical planning for thyroid nodules in children and adolescents. This study aims to:

1.       Assess the performance of TI-RADS with pediatric size modifications.

2.       Evaluate the utility and applicability of molecular testing for indeterminate cytology.

Study Investigators: Jennifer Aldrink, MD and Emily Christison-Lagay, MD


Contact Chloé Boehmer ( if you have any questions on how your site can participate in this study.

Thyroid ultrasound of papillary thyroid carcinoma (PTC).


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