{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T18:50:26Z","timestamp":1777575026477,"version":"3.51.4"},"reference-count":20,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2022,1,12]],"date-time":"2022-01-12T00:00:00Z","timestamp":1641945600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background: To evaluate the performance of TBSRTC through multi-institutional experience in the paediatric population and questioning the management recommendation of ATA Guidelines Task Force on Paediatric Thyroid Cancer; Methods: A retrospective search was conducted in 4 institutions to identify consecutive thyroid FNAC cases in paediatric population between 2000 and 2018. Following the 2nd TBSRTC, the risk of malignancy ratios (ROMs) was given in ranges and calculated by 2 different ways. Sensitivity, specificity, PPV, NPV and DA ratios were calculated using histologic diagnosis as the gold standard; Results: Among a total of 405 specimens, the distribution of cases for each category was, 44 (11%) for ND, 204 (50%) for B category, 40 (10%) for AUS\/FLUS, 36 (9%) for FN\/SFN, 24 (6%) for SFM and 57 (14%) for M categories. 153 cases have a histological diagnosis. The ratio of surgery was 23% in ND, 16% in the B, 45% for AUS\/FLUS, 75% for SFN\/FN and 92% for SFM and 75% in M categories; Conclusions: The data underlines the high ROM values in paediatric population which might be clinically meaningful. The high rate of malignancy of the cohort of operated patients (50%) also underlines the need of better preoperative indicators for stratification. Considering that more than half of the nodules in AUS\/FLUS category were benign, direct surgery recommendation could be questionable as proposed in ATA 2015 guidelines.<\/jats:p>","DOI":"10.3390\/diagnostics12010179","type":"journal-article","created":{"date-parts":[[2022,1,12]],"date-time":"2022-01-12T23:17:07Z","timestamp":1642029427000},"page":"179","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Performance of the Bethesda System for Reporting Thyroid Cytology in Multi-Institutional Large Cohort of Pediatric Thyroid Nodules: A Detailed Analysis"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3736-1323","authenticated-orcid":false,"given":"Sule","family":"Canberk","sequence":"first","affiliation":[{"name":"Instituto de Investiga\u00e7\u00e3o e Inova\u00e7\u00e3o em Sa\u00fade (i3S), University of Porto, Rua Alfredo Allen 208, 4200-135 Porto, Portugal"},{"name":"Institute of Molecular Pathology and Immunology of the University of Porto (Ipatimup), Rua J\u00falio Amaral de Carvalho 45, 4200-135 Porto, Portugal"},{"name":"Abel Salazar Biomedical Sciences Institute (ICBAS), University of Porto, Rua Jorge de Viterbo Ferreira 228, 4050-313 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5684-3523","authenticated-orcid":false,"given":"Helena","family":"Barroca","sequence":"additional","affiliation":[{"name":"Department of Pathology and Oncology, Centro Hospitalar S\u00e3o Jo\u00e3o, Alameda Professor Hern\u00e2ni Monteiro, 4200-319 Porto, Portugal"}]},{"given":"In\u00eas","family":"Gir\u00e3o","sequence":"additional","affiliation":[{"name":"Department of Biomedicine and Medicine, University of Algarve, 8005-139 Faro, Portugal"}]},{"given":"Ozlem","family":"Ayd\u0131n","sequence":"additional","affiliation":[{"name":"Department of Pathology, Medical Faculty, Acibadem University, Istanbul 34684, Turkey"}]},{"given":"Aysun","family":"Uguz","sequence":"additional","affiliation":[{"name":"Department of Pathology, Medical Faculty, \u00c7ukurova University, Adana 01330, Turkey"}]},{"given":"K\u0131v\u0131lc\u0131m","family":"Erdogan","sequence":"additional","affiliation":[{"name":"Department of Pathology, Medical Faculty, \u00c7ukurova University, Adana 01330, Turkey"}]},{"given":"Ebru","family":"Tastekin","sequence":"additional","affiliation":[{"name":"Department of Pathology, Medical Faculty, Trakya University, Edirne 22030, Turkey"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9846-6682","authenticated-orcid":false,"given":"Massimo","family":"Bongiovanni","sequence":"additional","affiliation":[{"name":"Synlab Pathology, Rue du Liseron 5, 1006 Lausanne, Switzerland"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9607-6998","authenticated-orcid":false,"given":"Paula","family":"Soares","sequence":"additional","affiliation":[{"name":"Instituto de Investiga\u00e7\u00e3o e Inova\u00e7\u00e3o em Sa\u00fade (i3S), University of Porto, Rua Alfredo Allen 208, 4200-135 Porto, Portugal"},{"name":"Institute of Molecular Pathology and Immunology of the University of Porto (Ipatimup), Rua J\u00falio Amaral de Carvalho 45, 4200-135 Porto, Portugal"},{"name":"Department of Pathology, Faculty of Medicine of the University of Porto (FMUP), Alameda Professor Hern\u00e2ni Monteiro, 4200-319 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8631-8356","authenticated-orcid":false,"given":"Valdemar","family":"M\u00e1ximo","sequence":"additional","affiliation":[{"name":"Instituto de Investiga\u00e7\u00e3o e Inova\u00e7\u00e3o em Sa\u00fade (i3S), University of Porto, Rua Alfredo Allen 208, 4200-135 Porto, Portugal"},{"name":"Institute of Molecular Pathology and Immunology of the University of Porto (Ipatimup), Rua J\u00falio Amaral de Carvalho 45, 4200-135 Porto, Portugal"},{"name":"Department of Pathology, Faculty of Medicine of the University of Porto (FMUP), Alameda Professor Hern\u00e2ni Monteiro, 4200-319 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1006-6946","authenticated-orcid":false,"given":"Fernando","family":"Schmitt","sequence":"additional","affiliation":[{"name":"Institute of Molecular Pathology and Immunology of the University of Porto (Ipatimup), Rua J\u00falio Amaral de Carvalho 45, 4200-135 Porto, Portugal"},{"name":"Department of Pathology, Faculty of Medicine of the University of Porto (FMUP), Alameda Professor Hern\u00e2ni Monteiro, 4200-319 Porto, Portugal"},{"name":"CINTESIS@RISE, Alameda Professor Hern\u00e2ni Monteiro, 4200-319 Porto, Portugal"}]}],"member":"1968","published-online":{"date-parts":[[2022,1,12]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1089\/thy.2015.0287","article-title":"Pediatric Differentiated Thyroid Carcinoma of Follicular Cell Origin: Prognostic Significance of Histologic 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