OCTON 360
Sign up
Early-detection demo · Thyroid · incidental

Sub-cm hypoechoic thyroid nodule with TIRADS 5 features

8 mm hypoechoic, taller-than-wide thyroid nodule with microcalcifications — TIRADS 5 (highly suspicious).

Patient: Priya · 38 · childhood neck irradiationModality: USRisk: elevated · 50/100
Share
01

Risk profile

What OCTON knew before the scan
Risk
50
elevated
Tier
elevated
Treated for Hodgkin lymphoma at age 12 with mantle-field radiation. Thyroid cancer is a known late-effect risk; lifetime risk ~6%.
Contributing factors
  • Childhood neck irradiation (mantle field)+25
  • Female+6
  • Age 38 (young adult, post-radiation latency 26 yrs)+8
  • Family history of differentiated thyroid cancer (paternal aunt)+6
  • Iodine sufficiency (normal)+5
Narrative

Priya carries a long-tail risk from childhood radiation. ATA 2015 recommends annual thyroid ultrasound starting 5 years post-radiation; her surveillance is appropriate. The lesion meets TIRADS 5 criteria.

02

Scan + AI report

What US found · Linear high-frequency neck ultrasound, longitudinal + transverse
US · DEMO
ACR-TIRADS TR5
OCTON · scanning · live
conf 0.86
OCTON Impression · 86% confidence

8 × 6 × 9 mm solid hypoechoic nodule in the left thyroid lobe (lower pole). Taller-than-wide on transverse, irregular margins, punctate echogenic foci consistent with microcalcifications. ACR-TIRADS 5 (TR5) — total score 9.

Findings
  • 8 × 6 × 9 mm solid hypoechoic nodule, left thyroid lobe lower pole · Left thyroid9 mm
  • Taller-than-wide configuration (TR2 +1) · Nodule
  • Irregular / lobulated margins (+2) · Nodule
  • Punctate echogenic foci (microcalcifications, +3) · Nodule interior
  • Solid composition (+2), hypoechoic (+2) · Nodule
  • No suspicious lateral cervical lymphadenopathy · Levels II–V
Differential diagnosis
  • Papillary thyroid microcarcinoma (PTMC)60%
  • Follicular variant papillary carcinoma18%
  • Atypia of undetermined significance (AUS/FLUS) on FNA15%
  • Benign nodular hyperplasia7%
Recommended actions
  • ▸Ultrasound-guided FNA (Bethesda category) given high-risk radiation history despite sub-cm size
  • ▸Bilateral neck ultrasound to map all nodules and lymph nodes
  • ▸Endocrine surgery consult if Bethesda V/VI
  • ▸Consider active surveillance if Bethesda VI low-risk PTMC and patient preference
Caveats
  • Most PTMCs are indolent; active-surveillance option (Ito et al. Kuma Hospital protocol) for selected cases.
  • Radiation-induced thyroid cancers are usually well-differentiated and curable.
03

360° Preventative plan

Drugs · surveillance · diet · exercise · lifestyle — generated for this case
Clinical anchors
Drugs · labs · imaging · surveillance
Medical
TSH + serum thyroglobulin
FrequencyAnnual
Startsage 17
ATA 2015
Monitoring
Thyroid + neck ultrasound
FrequencyAnnual · post-radiation surveillance
Startsage 17
ATA 2015 Pediatric DTC · COG long-term-follow-up guidelines
Monitoring
FNA biopsy of TIRADS 5 nodule
FrequencyWithin 4 weeks (current finding)
Startsage 38
ACR-TIRADS 2017 · ATA 2015 high-risk-history exception
04

What changed

The early-detection win

Priya's annual surveillance ultrasound surfaced an 8 mm hypoechoic taller-than-wide nodule with microcalcifications — TIRADS 5. Sub-cm typically wouldn't be biopsied, but OCTON flagged the radiation-history exception. FNA returned Bethesda VI papillary microcarcinoma. Hemithyroidectomy: T1a N0 M0, no extrathyroidal extension. 10-year disease-specific survival for Stage I PTMC: >99%.

Run this for yourself

Open the thyroid · incidental module on your own data.

Take the risk questionnaire, upload your scans, and have OCTON build your own preventative plan — same pipeline, your data.

Cancer module →Get started