한빛사논문
- 조회143
울산대학교
Pyeong Hwa Kim 1, Hee Mang Yoon 1, Jung Hwan Baek 1, Sae Rom Chung 1, Young Jun Choi 1, Jeong Hyun Lee 1, Jin Seong Lee 1, Ah Young Jung 1, Young Ah Cho 1, Boram Bak 1, Dong Gyu Na 1
1From the Department of Radiology and Research Institute of Radiology (P.H.K., H.M.Y., J.H.B., S.R.C., Y.J.C., J.H.L., J.S.L., A.Y.J., Y.A.C.) and University of Ulsan Foundation for Industry Cooperation (B.B.), Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Republic of Korea; Department of Radiology, GangNeung Asan Hospital, Gangneung, Republic of Korea (D.G.N.); and Department of Radiology, Human Medical Imaging and Intervention Center, Seoul, Republic of Korea (D.G.N.).
Address correspondence to J.H.B.
Abstract
Background
The validation of adult-based US risk stratification systems (RSSs) in the discrimination of malignant thyroid nodules in a pediatric population remains lacking.
Purpose
To estimate and compare the diagnostic performance of pediatric US RSSs based on five adult-based RSSs in the discrimination of malignant thyroid nodules in a pediatric sample.
Materials and methods
Pediatric patients (age ≤18 years) with histopathologically confirmed US-detected thyroid nodules at a tertiary referral hospital between January 2000 and April 2020 were analyzed retrospectively. The diagnostic performance of US-based fine-needle aspiration biopsy (FNAB) criteria in thyroid cancer detection was estimated. The following sensitivity analyses were performed: (a) scenario 1: nodules smaller than 1 cm, with the highest category additionally biopsied; (b) scenario 2, application of American College of Radiology Thyroid Imaging Reporting and Data System nodule size cutoffs to other RSSs; (c) scenario 3, scenarios 1 and 2 together. Generalized estimating equations (GEEs) were used for estimation.
Results
A total of 277 thyroid nodules in 221 pediatric patients (median age, 16 years [interquartile range {IQR}, 13–17]; 172 female; 152 of 277 patients [55%] malignant) were analyzed. The GEE-estimated sensitivity and specificity ranged from 70% to 78% (104 to 119 of 152 patients, based on each reader’s interpretation) and from 42% to 78% (49 of 124 patients to 103 of 125 patients). In scenario 1, the missed malignancy rate was reduced from 32%–38% (41 of 134 patients to 34 of 83 patients) to 15%–21% (eight of 59 patients to 28 of 127 patients). In scenario 2, the unnecessary biopsy rate was reduced from 35%–39% (60 of 176 patients to 68 of 175 patients) to 20%–34% (18 of 109 patients to 62 of 179 patients). The highest accuracy was noted in scenario 3 (range, 71%–81%; 199 of 277 patients to 216 of 262 patients).
Conclusion
The diagnostic performances of the fine-needle aspiration biopsy criteria of five adult-based risk stratification systems were acceptable in the pediatric population and were improved by applying the American College of Radiology Thyroid Imaging Reporting and Data System size cutoff for nodules 1 cm or larger and allowing biopsy of the highest category nodules smaller than 1 cm.
논문정보
- Research article
- 2022년 07월 (BRIC 등록일 2023-01-30)
- 국내 연구진
댓글 작성 로그인
팝업 닫기관련 링크
연구자 키워드
연구자 ID
관련분야 연구자보기
소속기관 논문보기
관련분야 논문보기
해당논문 저자보기
