Validity of the American College of Radiology Thyroid Imaging Reporting and Data System in Children

Objective To assess the validity of the American College of Radiology Thyroid Imaging Reporting and Data System (ACR TI‐RADS) for evaluating thyroid nodules in children. Methods Patients aged 3 as the threshold for malignancy correctly categorized the greatest percentage of nodules (68.9%). Eleven (18.6%) malignant nodules received a TI‐RADS level of 2 (n = 3) or 3 (n = 8). Sensitivity, specificity, and positive and negative predictive values were 81.4%, 53.2%, 68.6%, and 69.4%, respectively. Although not part of TI‐RADS, vascularity was similar between benign and malignant nodules (p = 0.56). Conclusion In a pediatric population, TI‐RADS can help distinguish between benign and malignant nodules with comparable sensitivity and specificity to adults. However, the positive and negative predictive values suggest TI‐RADS alone cannot eliminate the need for FNA. Level of Evidence 3 Laryngoscope, 133:2394–2401, 2023 In this retrospective study, ultrasound images of 106 nodules were graded according to ACR TI‐RADS criteria. Sensitivity, specificity, and positive and negative predictive values were 81.4%, 53.2%, 68.6%, and 69.4%, respectively. ROC analysis defined a threshold of >3 for malignancy and correctly categorized 68.9% of nodules.