Thyroid Nodules in Children 101: Can Ultrasound be Used to Diagnose a Benign Thyroid Nodule Alone without a Biopsy? Probably Not.

Thyroid Nodules in Children 101: Can Ultrasound US be Used to Diagnose a Benign Thyroid Nodule Alone without a Biopsy? Probably Not.

Gannon A.W. et al

JCEM May 2018 103(5) : 1958-1965

Diagnostic Accuracy of Ultrasound in Children with thyroid nodules.

Dr.Guttler comments on this article.

1. Can US predict a low risk for cancer?
2. 417 patients.157/417 had follow up.
3. 89% the US diagnosed a benign nodule.
4. US is useful for evaluation of childhood nodules.
5. However there were no combinations of findings sufficient to exclude thyroid cancer.
6. A thyroid biopsy was essential to not miss a thyroid cancer in childhood nodules.
7. Nodules with >25% cyst were the least likely to be cancer but even that group had a higher incidence of cancer than adults.
8. Guidelines recommend biopsy all thyroid nodules > 1 cm and/or with high risk features.
9. The study results were unable to identify a group that  US could be used in place of a biopsy.