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A Swin Transformer-Based Model for Thyroid Nodule Detection in Ultrasound Images
Published on: April 21, 2023
Sonographic Evaluation of Pediatric Thyroid Nodules
Alex C Essenmacher1, Peter H Joyce1, Simon C Kao1
1From the Department of Radiology (A.C.E., S.C.K., M.P.D., Y.S.) and Stead Family Department of Pediatrics (L.M.P.), University of Iowa Hospitals and Clinics, 200 Hawkins Dr, Iowa City, IA 52246; the University of Central Florida College of Medicine, Orlando, Fla (P.H.J.); and the Department of Radiology, Nemours Children's Health System, Nemours Children's Hospital, Orlando, Fla (M.E., C.M.J., D.J.P.).
Insights
Pediatric thyroid nodules require a modified ultrasonography (US) approach due to higher malignancy risk. This review details US features, clinical factors, and management strategies for pediatric thyroid cancer.
Area of Science:
- Radiology
- Pediatric Endocrinology
- Oncology
Background:
- Thyroid nodules are common in adults but less so in children.
- Pediatric thyroid nodules have a higher probability of malignancy compared to adults.
- A systematic ultrasonography (US) approach is crucial for evaluating thyroid nodules.
Purpose of the Study:
- To review US features of pediatric thyroid nodules and their predictive capacity for malignancy.
- To discuss clinical information, risk factors, and genetic syndromes relevant to pediatric thyroid cancer.
- To explore current literature, controversies, and management strategies for pediatric thyroid cancer.
Main Methods:
- Review of ultrasonography (US) features of thyroid nodules.
- Analysis of clinical information, risk factors, and genetic syndromes in pediatric patients.
- Synthesis of current literature and expert consensus on diagnosis and management.
Main Results:
- Specific US features can predict malignancy risk in pediatric thyroid nodules.
- Clinical factors and genetic syndromes are important indicators for early manifestation of thyroid malignancy.
- Established risk stratification models aid in guiding management and biopsy decisions.
Conclusions:
- A modified US evaluation strategy is essential for pediatric thyroid nodules.
- Understanding pediatric-specific clinical features and risk factors improves cancer detection.
- Further research and standardized guidelines are needed for optimal diagnosis and management of pediatric thyroid cancer.
Abstract:
A thyroid nodule detected clinically or incidentally at medical imaging is a common indication for ultrasonography (US) in the adult population. This scenario is less frequently the case in pediatric patients, and the approach to evaluation of thyroid nodules deserves modification in these patients because of the increased probability of malignancy in children, compared with adults. Evaluating a thyroid nodule with US in a systematic way requires familiarity with a number of features that can be assessed and the terms that the radiologist uses in each category. The probability of malignancy is influenced by certain features, and several models have emerged to integrate these details into an overall risk assessment to guide management and biopsy of thyroid nodules. Clinical features of thyroid cancer differ between pediatric and adult patients, and risk factors and certain genetic syndromes portend earlier manifestation of thyroid malignancy. This article provides a review of (a) US features of thyroid nodules with an emphasis on the predictive capacity for malignancy, focused on the pediatric age group when the data exist, (b) clinical information, including risk factors and genetic syndromes pertinent to the pediatric population, and (c) the state of the current literature and controversies in diagnosing and managing pediatric thyroid cancer. ©RSNA, 2017.
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