Utility of thyroid nodule to thyroid lobe volume ratio to measure fine needle aspiration cytologic malignancy risk of thyroid nodules in the pediatric population.

Authors

Frantzlee LaCrete, Blake Welker, Andrew Li, Alessandra Manoylova-Vedder, Naim Mitre, Meghan Tracy, David D Williams, Yoon Cho, John P Dahl

Published in

International journal of pediatric otorhinolaryngology. Volume 211. Pages 113047. Oct 13, 2026. Epub Oct 13, 2026.

Abstract

Pediatric thyroid cancer incidence is rising, but ultrasound (US) surveillance and biopsy thresholds remain highly debated due to multiple practice guidelines and limited supporting evidence.
To evaluate thyroid nodule to lobe (NL) volume ratios across ultrasound-guided fine-needle aspiration (FNA) biopsy status, pathology, and TI-RADS recommendation criteria.
After IRB approval, we retrospectively reviewed patients less than 21 years old who underwent thyroid US and FNA at a single institution (Figure 1). Nodule volume was divided by lobe volume to yield the volume ratio. Two-sample Wilcoxon rank-sum (Mann-Whitney) tests evaluated the ratio by biopsy status, Bethesda classification (BC), and TI-RADS criteria recommendation (Figure 2).
Among 122 patients, 92 (75.4%) were female and 30 (24.6%) were male; 379 nodules met the criteria for US review. The median NL ratio for the biopsy group was higher than the no biopsy group [0.14 (IQR: 0.04,0.38) vs 0.03 (IQR: 0.01,0.07); p < 0.0001]. When evaluating the BC to the NL ratio, there were 114 individuals with 323 eligible nodules. The median NL ratio was higher in the malignant group compared to the not malignant group [0.26 (IQR: 0.11,0.50) vs 0.12 (IQR: 0.04,0.34); p = 0.0032]. Additionally, the median NL ratio was greater for the TI-RADS biopsy recommended group compared to no TI-RADS biopsy recommended group [0.34 (IQR: 0.17,0.57) vs 0.05 (IQR: 0.03,0.12); p < 0.001].
We found significantly greater NL ratios in pediatric patients with malignant thyroid FNAs. Higher NL ratios were found for individuals meeting criteria for biopsy based on TI-RADS. Further investigation is warranted to assess the NL ratio as an objective adjunct for determining pediatric thyroid nodule biopsy thresholds and optimizing US-based surveillance in the pediatric population.

PMID:
42893658
Bibliographic data and abstract were imported from PubMed on 19 Oct 2026.

Read full publication at:
Please sign in to see all details.

Stats

1-terrible, 9-excellent. How would you rate this publication? Sign in in to submit your rating.

Post a comment

You need to be signed in to post comments. You can sign in here.

Comments

There are no comments yet.