{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T08:36:54Z","timestamp":1782895014948,"version":"3.54.5"},"reference-count":30,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>This study aims to evaluate the diagnostic performance of the American College of Radiology Thyroid Imaging Reporting and Data System (ACR-TIRADS) and the Chinese Thyroid Imaging Reporting and Data System (C-TIRADS) in differentiating between malignant and benign thyroid nodules in the pediatric population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>In this retrospective, single-center study, a total of 461 thyroid nodules from 393 pediatric patients (median age, 16.0 years; 91 boys) from September 2018 to November 2024 were analyzed. All diagnostic performance results are reported on a per-nodule basis. Scenario 1 (biopsy recommended for ACR-TR3 nodules \u226535 mm and all ACR-TR5 nodules) and Scenario 2 (biopsy recommended for all C-TR4B, C-TR4C, and C-TR5 nodules, with no biopsy for C-TR4A) were adopted to indicate biopsy. The diagnostic performance, unnecessary biopsy rates, and biopsy triage failure rates of ACR-TIRADS, C-TIRADS, Scenario 1, and Scenario 2 were estimated and compared.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The area under the receiver operating characteristic curve for Scenario 1 and Scenario 2 was significantly higher than that of ACR-TIRADS and C-TIRADS, respectively [0.793 (95% CI: 0.753 -0.829) vs. 0.663 (95% CI: 0.618 -0.706) and 0.825 (95% CI: 0.787 -0.858) vs. 0.689 (95% CI: 0.645 -0.731); both\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&amp;lt;\u00a00.01] Furthermore, both scenarios demonstrated lower unnecessary biopsy rates (47.5% vs. 60.1% for Scenario 1; 30.6% vs. 56.8% for Scenario 2) and biopsy triage failure rates (5.4% vs. 13.6% for Scenario 1; 8.8% vs. 12.8% for Scenario 2) compared to the corresponding TIRADS systems.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>These findings suggest that the application of Scenario 1 and Scenario 2 can improve diagnostic performance and reduce both unnecessary biopsy rates and biopsy triage failure rates in identifying malignant thyroid nodules in the pediatric population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fendo.2026.1830933","type":"journal-article","created":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T07:00:40Z","timestamp":1782889240000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Diagnostic performance of adult-based ultrasound ACR-TIRADS and C-TIRADS in adolescent thyroid nodules"],"prefix":"10.3389","volume":"17","author":[{"given":"Jieyu","family":"Liu","sequence":"first","affiliation":[{"name":"Department of Ultrasound, The Second Xiangya Hospital, Central South University","place":["Changsha, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chengxue","family":"Jiang","sequence":"additional","affiliation":[{"name":"Department of Ultrasound, The Second Xiangya Hospital, Central South University","place":["Changsha, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoye","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Ultrasound, The Second Xiangya Hospital, Central South University","place":["Changsha, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taiqing","family":"Zheng","sequence":"additional","affiliation":[{"name":"Department of Pathology, Children\u2019s Hospital, Central South University","place":["Changsha, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Minghui","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Ultrasound, The Second Xiangya Hospital, Central South University","place":["Changsha, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guotao","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Ultrasound, The Second Xiangya Hospital, Central South University","place":["Changsha, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,1]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoto.2019.0898","article-title":"Pediatric thyroid cancer incidence and mortality trends in the United States, 1973-2013","volume":"145","author":"Qian","year":"2019","journal-title":"JAMA Otolaryngol Head Neck 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