TI‐RADS and Bethesda Classification System Correlate With Predicting Pediatric Papillary Thyroid Carcinoma

• DOI: 10.1002/ohn.1310
• Publication Date: 2025-05-16T08:35:49Z
• Authors: Shaunak N. Amin; Megan Branson; J. Nathaniel Perkins; Xing Wang; Eric C. Huang; Tyler G. Ketterl; Hedieh Khalatbari; Sanjay R. Parikh; Scott C. Manning; John P. Dahl

AbstractObjectiveOur study objectives were to evaluate the relationship between Thyroid Imaging Reporting and Data System (TI‐RADS) and Bethesda classification and to compare both TI‐RADS and Bethesda classification for the diagnosis of papillary thyroid carcinoma (PTC) within the pediatric population.Study DesignRetrospective case series.SettingAcademic pediatric hospital.MethodsA 13‐year retrospective review was performed of all pediatric patients undergoing thyroid fine needle aspiration (FNA) and ultrasound at our institution. Demographics, TI‐RADS scoring, FNA results, surgical history, and final pathology were collected. High‐risk ultrasonography and cytopathology were defined as TI‐RADS 3‐5 and Bethesda 5‐6, respectively. Spearman's rank correlation was determined for TI‐RADS and Bethesda classification. Relative risks of high‐risk TI‐RADS and Bethesda classification for predicting PTC were calculated.ResultsA total of 157 patients (21.7% male, median age at time of FNA 15 years, and range 2.7‐21 years) underwent ultrasound and FNA during the study. The Spearman's rank correlation coefficient for TI‐RADS compared with the Bethesda classification was 0.41 (P < .001). The relative risk of high‐risk TI‐RADS scores to predict the presence of PTC was 7.99 (95% CI 1.16‐54.90). High‐risk Bethesda classification demonstrated a relative risk for predicting PTC of 6.62 (95% CI 4.22‐10.41).ConclusionIn our cohort, there was a moderate correlation between TI‐RADS and Bethesda classifications. Patients with a TI‐RADS score ≥3 and Bethesda classification 3 or 4 are at intermediate risk for harboring PTC and should be counseled accordingly.