TI-RADS and Bethesda Classification System Correlate With Predicting Pediatric Papillary Thyroid Carcinoma

Area of Science:

• Pediatric Endocrinology
• Diagnostic Imaging
• Cytopathology

Background:

• Thyroid nodules are common in children, requiring accurate risk stratification.
• Thyroid Imaging Reporting and Data System (TI-RADS) and Bethesda classification are standard tools for evaluating thyroid nodules.
• Understanding the relationship between these systems is crucial for pediatric thyroid nodule management.

Purpose of the Study:

• To evaluate the relationship between TI-RADS and Bethesda classification in pediatric thyroid nodules.
• To compare the diagnostic performance of TI-RADS and Bethesda classification for papillary thyroid carcinoma (PTC) in children.

Main Methods:

• Retrospective case series of 157 pediatric patients undergoing thyroid ultrasound and fine needle aspiration (FNA).
• Analysis of demographics, TI-RADS scores, Bethesda classifications, and final pathology.
• Calculation of Spearman's rank correlation and relative risks for predicting PTC.

Main Results:

• A moderate correlation (Spearman's rho = 0.41, P < .001) was observed between TI-RADS and Bethesda classifications.
• High-risk TI-RADS (≥3) showed a relative risk of 7.99 for predicting PTC.
• High-risk Bethesda classification (5-6) showed a relative risk of 6.62 for predicting PTC.

Conclusions:

• A moderate correlation exists between TI-RADS and Bethesda classifications in pediatric thyroid nodules.
• Patients with TI-RADS ≥3 and Bethesda 3-4 are at intermediate risk for PTC and require careful counseling.
• These findings support the combined use of TI-RADS and Bethesda classification for improved risk assessment in pediatric thyroid nodules.