Validation of ACR TI-RADS performance in transition age: results from a multicenter retrospective study by the TALENT study group.

Autor: Grani G; Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy., Stramazzo I; Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy., Locantore P; Endocrinology Unit, Fondazione Policlinico Universitario Agostino Gemelli-IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy., Virili C; Endocrinology Unit, Department of Medico-Surgical Sciences and Biotechnologies, 'Sapienza' University of Rome, Latina, Italy., Filardi T; Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, Rome, Italy., Lecis C; Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy., Centello R; Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy., Cera G; Endocrinology Unit, Fondazione Policlinico Universitario Agostino Gemelli-IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy., Santaguida MG; Endocrinology Unit, AUSL, Latina, Italy., Gianfrilli D; Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy., Isidori AM; Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy., Durante C; Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy. Cosimo.durante@uniroma1.it., Pozza C; Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy. carlotta.pozza@uniroma1.it.
Jazyk: angličtina
Zdroj: Endocrine [Endocrine] 2024 Dec 13. Date of Electronic Publication: 2024 Dec 13.
DOI: 10.1007/s12020-024-04117-3
Abstrakt: Purpose: Although thyroid nodules are less common in the pediatric population, the risk of malignancy is higher than in adult patients. The aim of this study was to evaluate the ultrasonographic predictive factors of malignancy in thyroid nodules and to validate American College of Radiologists (ACR) TI-RADS performance in transition age patients.
Methods: One hundred forty-two patients aged between 14 and 21 years referred to the participating centers for FNA biopsy of a thyroid nodule between 2007 and 2022 were included and ultrasound reports and sonographic images were retrospectively analyzed. Nodule features were defined according to the ACR-TIRADS lexicon. Two reference standards were applied: FNA cytology and surgical histology. The diagnostic performance of single sonographic features was estimated. Significant predictors were then included in a multivariate regression model.
Results: Nodules included in ACR-TIRADS categories TR4 or TR5 had 10-fold increased risk of indeterminate or suspicious/malignant cytology [p < 0.001]. In univariate analysis, solid composition [p = 0.016] and presence of hyperechoic foci [p = 0.040] significantly increased the likelihood of malignant histology. In multivariate regression analysis, irregular margins [p = 0.011] and hyperechoic foci [p = 0.019] were independent predictors of indeterminate or suspicious/malignant cytology.
Conclusion: Nodules included in ACR-TIRADS categories TR4 or TR5 had 10-fold increased risk of indeterminate or suspicious/malignant cytology in transition age. ACR-TIRADS was not able to rule-out malignancy compared to FNAB alone, suggesting the need to reconsider recommendations in the transition age group.
Competing Interests: Compliance with ethical standards. Conflict of interest: G.G. and D.G. are associated editors of Endocrine. Cosimo Durante is a member of Endocrine Editorial Board. They will not be involved in the editorial review or the decision to publish this article. The other authors have no competing interest to declare that are relevant to the content of this article. Ethics approval: This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Sapienza University of Rome Ethics Committee, reference 7141, Prot. 0418/2023. Informed consent was obtained from all individual participants included in the study.
(© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
Databáze: MEDLINE
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