Pediatric thyroid nodules: ultrasonographic characteristics and inter-observer variability in prediction of malignancy
Pediatric thyroid nodules, while uncommon, have high malignancy risk. The objectives of the study were (1) to identify sonographic features predictive of malignancy; (2) to create a prediction model; and (3) to assess inter-observer agreement among radiologists. All available cases of thyroid nodule...
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| Published in | Journal of Pediatric Endocrinology & Metabolism Vol. 29; no. 7; pp. 789 - 794 |
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| Main Authors | , , , , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
Germany
De Gruyter
01.07.2016
Walter de Gruyter GmbH |
| Subjects | |
| Online Access | Get full text |
| ISSN | 0334-018X 2191-0251 |
| DOI | 10.1515/jpem-2015-0242 |
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| Abstract | Pediatric thyroid nodules, while uncommon, have high malignancy risk. The objectives of the study were (1) to identify sonographic features predictive of malignancy; (2) to create a prediction model; and (3) to assess inter-observer agreement among radiologists.
All available cases of thyroid nodules, surgically removed between 2000 and 2009. Three radiologists reviewed the sonographic images; 2 pathologists reviewed the tissue specimens. Adult prediction models were applied. Interobserver variability was assessed.
Twenty-seven subjects, mean age 13.1±3.4 years, were included. Nineteen nodules were differentiated thyroid carcinomas. On multivariate analysis, size was the only significant predictor of malignancy. On recursive partitioning analysis, size >35 mm with microcalcification and ill-defined margins yielded the best prediction model. Radiologist inter-observer agreement regarding malignancy was moderate (κ=0.50).
Larger size, microcalcifications and ill-defined margins on ultrasound demonstrate the best predictive model for malignancy in the pediatric population. Experienced pediatric radiologists demonstrate moderate inter-observer agreement in prediction of malignancy. |
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| AbstractList | BACKGROUNDPediatric thyroid nodules, while uncommon, have high malignancy risk. The objectives of the study were (1) to identify sonographic features predictive of malignancy; (2) to create a prediction model; and (3) to assess inter-observer agreement among radiologists.METHODSAll available cases of thyroid nodules, surgically removed between 2000 and 2009. Three radiologists reviewed the sonographic images; 2 pathologists reviewed the tissue specimens. Adult prediction models were applied. Interobserver variability was assessed.RESULTSTwenty-seven subjects, mean age 13.1±3.4 years, were included. Nineteen nodules were differentiated thyroid carcinomas. On multivariate analysis, size was the only significant predictor of malignancy. On recursive partitioning analysis, size >35 mm with microcalcification and ill-defined margins yielded the best prediction model. Radiologist inter-observer agreement regarding malignancy was moderate (κ=0.50).CONCLUSIONSLarger size, microcalcifications and ill-defined margins on ultrasound demonstrate the best predictive model for malignancy in the pediatric population. Experienced pediatric radiologists demonstrate moderate inter-observer agreement in prediction of malignancy. Background: Pediatric thyroid nodules, while uncommon, have high malignancy risk. The objectives of the study were (1) to identify sonographic features predictive of malignancy; (2) to create a prediction model; and (3) to assess inter-observer agreement among radiologists. Methods: All available cases of thyroid nodules, surgically removed between 2000 and 2009. Three radiologists reviewed the sonographic images; 2 pathologists reviewed the tissue specimens. Adult prediction models were applied. Interobserver variability was assessed. Results: Twenty-seven subjects, mean age 13.1±3.4 years, were included. Nineteen nodules were differentiated thyroid carcinomas. On multivariate analysis, size was the only significant predictor of malignancy. On recursive partitioning analysis, size >35 mm with microcalcification and ill-defined margins yielded the best prediction model. Radiologist inter-observer agreement regarding malignancy was moderate (κ=0.50). Conclusions: Larger size, microcalcifications and ill-defined margins on ultrasound demonstrate the best predictive model for malignancy in the pediatric population. Experienced pediatric radiologists demonstrate moderate inter-observer agreement in prediction of malignancy. Pediatric thyroid nodules, while uncommon, have high malignancy risk. The objectives of the study were (1) to identify sonographic features predictive of malignancy; (2) to create a prediction model; and (3) to assess inter-observer agreement among radiologists. All available cases of thyroid nodules, surgically removed between 2000 and 2009. Three radiologists reviewed the sonographic images; 2 pathologists reviewed the tissue specimens. Adult prediction models were applied. Interobserver variability was assessed. Twenty-seven subjects, mean age 13.1±3.4 years, were included. Nineteen nodules were differentiated thyroid carcinomas. On multivariate analysis, size was the only significant predictor of malignancy. On recursive partitioning analysis, size >35 mm with microcalcification and ill-defined margins yielded the best prediction model. Radiologist inter-observer agreement regarding malignancy was moderate (κ=0.50). Larger size, microcalcifications and ill-defined margins on ultrasound demonstrate the best predictive model for malignancy in the pediatric population. Experienced pediatric radiologists demonstrate moderate inter-observer agreement in prediction of malignancy. |
| Author | Ngan, Bo García, Cristián Koltin, Dror Murphy, Amanda Navarro, Oscar M. Wasserman, Jonathan D. Rachmiel, Marianna Atenafu, Eshetu G. Daneman, Alan O’Gorman, Clodagh S. Hamilton, Jill |
| Author_xml | – sequence: 1 givenname: Dror surname: Koltin fullname: Koltin, Dror – sequence: 2 givenname: Clodagh S. surname: O’Gorman fullname: O’Gorman, Clodagh S. email: clodagh.ogorman@ul.ie – sequence: 3 givenname: Amanda surname: Murphy fullname: Murphy, Amanda organization: Division of Pathology and Laboratory Medicine, Department of Cellular Pathology, The Hospital for Sick Children, University of Toronto, ON, Canada – sequence: 4 givenname: Bo surname: Ngan fullname: Ngan, Bo organization: Division of Pathology and Laboratory Medicine, Department of Cellular Pathology, The Hospital for Sick Children, University of Toronto, ON, Canada – sequence: 5 givenname: Alan surname: Daneman fullname: Daneman, Alan organization: Department of Diagnostic Imaging and Medical Imaging, University of Toronto, ON, Canada – sequence: 6 givenname: Oscar M. surname: Navarro fullname: Navarro, Oscar M. organization: Department of Diagnostic Imaging and Medical Imaging, University of Toronto, ON, Canada – sequence: 7 givenname: Cristián surname: García fullname: García, Cristián organization: Department of Radiology and Pediatrics, Pontificia Universidad Católica, Santiago, Chile – sequence: 8 givenname: Eshetu G. surname: Atenafu fullname: Atenafu, Eshetu G. organization: Biostatistics Department, Princess Margaret Cancer Center, University Health Network, Toronto, ON, Canada – sequence: 9 givenname: Jonathan D. surname: Wasserman fullname: Wasserman, Jonathan D. organization: Division of Endocrinology, Department of Paediatrics, The Hospital for Sick Children, University of Toronto, ON, Canada – sequence: 10 givenname: Jill surname: Hamilton fullname: Hamilton, Jill organization: Division of Endocrinology, Department of Paediatrics, The Hospital for Sick Children, University of Toronto, ON, Canada – sequence: 11 givenname: Marianna surname: Rachmiel fullname: Rachmiel, Marianna organization: Pediatric Endocrinology Unit, Assaf Haroffeh Medical Center, Tel Aviv University, Israel |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/27089403$$D View this record in MEDLINE/PubMed |
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| Snippet | Pediatric thyroid nodules, while uncommon, have high malignancy risk. The objectives of the study were (1) to identify sonographic features predictive of... Background: Pediatric thyroid nodules, while uncommon, have high malignancy risk. The objectives of the study were (1) to identify sonographic features... BACKGROUNDPediatric thyroid nodules, while uncommon, have high malignancy risk. The objectives of the study were (1) to identify sonographic features... |
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| SubjectTerms | Adolescent Carcinoma - diagnostic imaging Carcinoma - epidemiology Carcinoma - pathology Carcinoma - surgery Child Child, Preschool Cohort Studies Decalcification, Pathologic - diagnostic imaging Decalcification, Pathologic - epidemiology Decalcification, Pathologic - pathology Decalcification, Pathologic - surgery Diagnosis, Differential Female Hospitals, Pediatric Humans inter-observer variability Male Observer Variation Ontario - epidemiology prediction model Predictive Value of Tests Reproducibility of Results Retrospective Studies Risk thyroid carcinoma Thyroid Gland - diagnostic imaging Thyroid Gland - pathology Thyroid Gland - surgery Thyroid Neoplasms - diagnostic imaging Thyroid Neoplasms - epidemiology Thyroid Neoplasms - pathology Thyroid Neoplasms - surgery Thyroid Nodule - diagnostic imaging Thyroid Nodule - epidemiology Thyroid Nodule - pathology Thyroid Nodule - surgery thyroid nodules Tumor Burden Ultrasonography ultrasound |
| Title | Pediatric thyroid nodules: ultrasonographic characteristics and inter-observer variability in prediction of malignancy |
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