Ultrasonography and the Ultrasound-Based Management of Thyroid Nodules: Consensus Statement and Recommendations

The detection of thyroid nodules has become more common with the widespread use of ultrasonography (US). US is the mainstay for detecting and making the differential diagnosis of thyroid nodules as well as for providing guidance for a biopsy. The Task Force on Thyroid Nodules of the Korean Society of Thyroid Radiology has developed recommendations for the US diagnosis and US-based management of thyroid nodules. The review and recommendations in this report have been based on a comprehensive analysis of the current literature, the results of multicenter studies and from the consensus of experts.

[1]  K. Franssila,et al.  Occult papillary carcinoma of the thyroid. A “normal” finding in finland. A systematic autopsy study , 1985, Cancer.

[2]  K. Oh,et al.  Ultrasound-guided fine-needle aspiration biopsy in nonpalpable thyroid nodules: is it useful in infracentimetric nodules? , 2003, Yonsei medical journal.

[3]  E. Baudin,et al.  Microcarcinoma of the thyroid gland , 1998, Cancer.

[4]  H. Gharib,et al.  Endocrine University: evolution of a novel educational program. , 2006, Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists.

[5]  E. Cibas,et al.  The Bethesda System for Reporting Thyroid Cytopathology , 2009, Springer International Publishing.

[6]  L. Kivisaari,et al.  Importance of thyroid abnormalities detected at US screening: a 5-year follow-up. , 2000, Radiology.

[7]  Stephen Farrell,et al.  US Features of thyroid malignancy: pearls and pitfalls. , 2007, Radiographics : a review publication of the Radiological Society of North America, Inc.

[8]  S. Asa,et al.  Thyroid calcification and its association with thyroid carcinoma , 2002, Head & neck.

[9]  Anna Crescenzi,et al.  American Association of Clinical Endocrinologists and Associazione Medici Endocrinologi medical guidelines for clinical practice for the diagnosis and management of thyroid nodules. , 2006, Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists.

[10]  K. Wakasa,et al.  The Value of Ultrasound-Guided Fine-Needle Aspiration Cytology for Thyroid Nodules: An Assessment of Its Diagnostic Potential and Pitfalls , 2001, Surgery Today.

[11]  S. Jhiang,et al.  Long-term impact of initial surgical and medical therapy on papillary and follicular thyroid cancer. , 1994, The American journal of medicine.

[12]  E. Papini,et al.  Long-term changes in nodular goiter: a 5-year prospective randomized trial of levothyroxine suppressive therapy for benign cold thyroid nodules. , 1998, The Journal of clinical endocrinology and metabolism.

[13]  Chul Soon Choi,et al.  Peripheral Calcification in Thyroid Nodules , 2007, Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine.

[14]  P. Larsen,et al.  Natural History of Benign Solid and Cystic Thyroid Nodules , 2003, Annals of Internal Medicine.

[15]  Eun-Kyung Kim,et al.  Sonographic Differentiation of Thyroid Nodules With Eggshell Calcifications , 2008, Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine.

[16]  J. Charboneau,et al.  Sonography of Thyroid Nodules: A “Classic Pattern” Diagnostic Approach , 2005, Ultrasound quarterly.

[17]  J. Baek,et al.  Patterns and Significance of Peripheral Calcifications of Thyroid Tumors seen on Ultrasound , 2005 .

[18]  E. Mazzaferri,et al.  Should all patients with subcentimeter thyroid nodules undergo fine-needle aspiration biopsy and preoperative neck ultrasonography to define the extent of tumor invasion? , 2008, Thyroid : official journal of the American Thyroid Association.

[19]  G. Stuart,et al.  Cytopathology , 2012, Definitions.

[20]  J. Serpell,et al.  Management of the solitary thyroid nodule. , 2008, The oncologist.

[21]  W. Lau,et al.  Changes in clinical presentation, management and outcome in 1348 patients with differentiated thyroid carcinoma: experience in a single institute in Hong Kong, 1960-2000. , 2003, Clinical oncology (Royal College of Radiologists (Great Britain)).

[22]  References , 1971 .

[23]  T. Furlanetto,et al.  Ultrasonography: Is it useful in the diagnosis of cancer in thyroid nodules? , 2002, Journal of endocrinological investigation.

[24]  Anna Crescenzi,et al.  Risk of malignancy in nonpalpable thyroid nodules: predictive value of ultrasound and color-Doppler features. , 2002, The Journal of clinical endocrinology and metabolism.

[25]  R. Paschke,et al.  Interobserver variation for ultrasound determination of thyroid nodule volumes. , 2005, Thyroid : official journal of the American Thyroid Association.

[26]  H. Gharib,et al.  Thyroid Incidentalomas: Management Approaches to Nonpalpable Nodules Discovered Incidentally on Thyroid Imaging , 1997, Annals of Internal Medicine.

[27]  M. Karadeniz,et al.  Power Doppler US patterns of vascularity and spectral Doppler US parameters in predicting malignancy in thyroid nodules. , 2007, Clinical radiology.

[28]  F. Pacini,et al.  Clinical features and therapeutic implication of papillary thyroid microcarcinoma. , 2007, Thyroid : official journal of the American Thyroid Association.

[29]  Dong Ik Kim,et al.  New sonographic criteria for recommending fine-needle aspiration biopsy of nonpalpable solid nodules of the thyroid. , 2002, AJR. American journal of roentgenology.

[30]  P. Doubilet,et al.  Can Color Doppler Sonography Aid in the Prediction of Malignancy of Thyroid Nodules? , 2003, Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine.

[31]  A. Ahuja,et al.  Clinical significance of the comet‐tail artifact in thyroid ultrasound , 1996, Journal of clinical ultrasound : JCU.

[32]  Ho Kyu Lee,et al.  Ultrasonography‐guided fine‐needle aspiration of thyroid incidentaloma: correlation with pathological findings , 2004, Clinical endocrinology.

[33]  A. Miyauchi,et al.  An observation trial without surgical treatment in patients with papillary microcarcinoma of the thyroid. , 2003, Thyroid : official journal of the American Thyroid Association.

[34]  Andrzej Lewiński,et al.  The usefulness of sonographic features in selection of thyroid nodules for biopsy in relation to the nodule's size. , 2009, European journal of endocrinology.

[35]  H. Yamashita,et al.  Papillary Microcarcinoma , 2008, World Journal of Surgery.

[36]  Terry S Desser,et al.  Common and Uncommon Sonographic Features of Papillary Thyroid Carcinoma , 2003, Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine.

[37]  J. Amano,et al.  The rate of tumour growth does not distinguish between malignant and benign thyroid nodules. , 2001, The European journal of surgery = Acta chirurgica.

[38]  Mary C Frates,et al.  Assessment of nondiagnostic ultrasound-guided fine needle aspirations of thyroid nodules. , 2002, The Journal of clinical endocrinology and metabolism.

[39]  W. Moon,et al.  Are there any specific ultrasound findings of nodular hyperplasia (“leave me alone” lesion) to differentiate it from follicular adenoma? , 2009, Acta radiologica.

[40]  A. Osborn.  Partially Cystic Thyroid Nodules on Ultrasound: Probability of Malignancy and Sonographic Differentiation , 2010 .

[41]  A. Ahuja,et al.  Role of ultrasound in the management of thyroid nodules. , 1992, American journal of surgery.

[42]  K. Zou,et al.  Sonographic Features of Benign Thyroid Nodules , 2003, Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine.

[43]  Michael Macari,et al.  Pattern recognition of benign nodules at ultrasound of the thyroid: which nodules can be left alone? , 2009, AJR. American journal of roentgenology.

[44]  Stephanie L. Lee,et al.  Revised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer. , 2009, Thyroid : official journal of the American Thyroid Association.

[45]  A. Stavros,et al.  Solid breast nodules: use of sonography to distinguish between benign and malignant lesions. , 1995, Radiology.

[46]  Jin Young Kwak,et al.  Can vascularity at power Doppler US help predict thyroid malignancy? , 2010, Radiology.

[47]  J Nickels,et al.  Thyroid gland: US screening in a random adult population. , 1991, Radiology.

[48]  Evaluating the Degree of Conformity of Papillary Carcinoma and Follicular Carcinoma to the Reported Ultrasonographic Findings of Malignant Thyroid Tumor , 2007, Korean journal of radiology.

[49]  M. Rho,et al.  Ultrasound-guided fine-needle aspiration biopsy of thyroid nodules: comparison in efficacy according to nodule size. , 2009, Thyroid : official journal of the American Thyroid Association.

[50]  I. Nakayama,et al.  Small carcinomas of the thyroid. A long-term follow-up of 867 patients. , 1996, Archives of surgery.

[51]  H. Hatabu,et al.  Cystic papillary carcinoma of the thyroid gland: a new sonographic sign. , 1991, Clinical radiology.

[52]  A. Atri,et al.  Thyroid nodule shape and prediction of malignancy. , 2004, Thyroid : official journal of the American Thyroid Association.

[53]  Eun-Kyung Kim,et al.  Value of US correlation of a thyroid nodule with initially benign cytologic results. , 2010, Radiology.

[54]  Jeong Hyun Lee,et al.  Benign and malignant thyroid nodules: US differentiation--multicenter retrospective study. , 2008, Radiology.

[55]  K. Togashi,et al.  Thyroid gland tumor diagnosis at US elastography. , 2005, Radiology.

[56]  C Lu,et al.  Ultrasonographic findings of papillary thyroid carcinoma and their relation to pathologic changes. , 1994, Journal of the Formosan Medical Association = Taiwan yi zhi.

[57]  K. Chang,et al.  Sonographic Features of Follicular Variant Papillary Thyroid Carcinomas in Comparison With Conventional Papillary Thyroid Carcinomas , 2009, Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine.

[58]  A. Miyauchi,et al.  Fate of untreated benign thyroid nodules: Results of long-term follow-up , 1994, World Journal of Surgery.

[59]  M. Skolnick,et al.  The nonspecificity of the thyroid halo sign , 1980, Journal of clinical ultrasound : JCU.

[60]  R. Jeffrey,et al.  Management of thyroid nodules detected at US: Society of Radiologists in Ultrasound consensus conference statement. , 2005, Ultrasound quarterly.

[61]  Jee-Young Kim,et al.  Ultrasonographic Findings of Medullary Thyroid Carcinoma: a Comparison with Papillary Thyroid Carcinoma , 2009, Korean journal of radiology.

[62]  M. Erdoğan,et al.  Natural course of benign thyroid nodules in a moderately iodine‐deficient area , 2006, Clinical endocrinology.

[63]  W C Black,et al.  Advances in diagnostic imaging and overestimations of disease prevalence and the benefits of therapy. , 1993, The New England journal of medicine.

[64]  J. Cronan,et al.  Risk for Malignancy of Thyroid Nodules as Assessed by Sonographic Criteria , 2004, Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine.