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Early-detection demo · Thyroid cancer

ACR-TIRADS TR5 papillary cancer in childhood-radiation survivor

1.4 cm hypoechoic, taller-than-wide nodule with microcalcifications · ACR-TIRADS TR5.

Patient: Jasmine · 42 · Hodgkin survivorModality: USRisk: high · 75/100
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01

Risk profile

What OCTON knew before the scan
Risk
75
high
Tier
high
Hodgkin's lymphoma at age 14 → 35 Gy mantle radiation. Annual neck US since age 28. New 1.4 cm hypoechoic nodule with microcalcifications.
Contributing factors
  • Childhood mantle radiation (35 Gy)+38
  • Age 14 at exposure+14
  • Female sex+6
  • Latency ~28 years+12
  • Family history negative+0
  • Iodine-replete diet+-2
Narrative

Childhood neck radiation drives a lifelong papillary-thyroid risk. Jasmine's annual surveillance — recommended by COG LTFU v6.0 — caught a TR5 nodule at 14 mm.

02

Scan + AI report

What US found · Thyroid ultrasound · linear 12 MHz
US · DEMO
ACR-TIRADS TR5
OCTON · scanning · live
conf 0.85
OCTON Impression · 84% confidence

Right thyroid lobe shows 1.4 cm hypoechoic, taller-than-wide nodule with microcalcifications and lobulated margins. ACR-TIRADS TR5 (highly suspicious).

Findings
  • 1.4 cm hypoechoic, taller-than-wide nodule · Right lobe mid14 mm
  • Microcalcifications · lobulated margins · Nodule
  • No abnormal cervical lymphadenopathy · Neck
Differential diagnosis
  • Papillary thyroid carcinoma (PTC)70%
  • Follicular variant PTC18%
  • Follicular adenoma8%
  • Benign hyperplastic nodule4%
Recommended actions
  • ▸Ultrasound-guided FNA with cytology (Bethesda)
  • ▸Endocrine surgery referral if Bethesda IV–VI
  • ▸Continue annual neck US per COG LTFU v6.0
Caveats
  • Childhood-radiation-induced PTC is typically multifocal — bilateral sampling recommended on surgery.
  • Most PTC is highly curable; total thyroidectomy + RAI cure rates > 90%.
03

360° Preventative plan

Drugs · surveillance · diet · exercise · lifestyle — generated for this case
Clinical anchors
Drugs · labs · imaging · surveillance
Medical
FNA on TR4 ≥ 1.5 cm / TR5 ≥ 1 cm
FrequencyAs indicated
Startsage 18
ACR-TIRADS White Paper 2017
Medical
Surgical pathology + post-op TSH
FrequencyOnce + lifelong
Startsage 18
ATA 2015
Monitoring
Thyroid ultrasound (ACR-TIRADS)
FrequencyAnnual
Startsage 25
Children's Oncology Group LTFU v6.0
04

What changed

The early-detection win

28 years post mantle radiation, annual neck US caught a TR5 nodule at 14 mm — early thyroidectomy yields > 90% cure.

Run this for yourself

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