Thyroid nodules: risk stratification for malignancy with ultrasound and guided biopsy
TLDR
The best tool for risk stratification for malignancy in thyroid nodules is US and guided biopsy of nodules with suspicious imaging features and fine-needle biopsy is currently the best triage test for pre-operative evaluation of a thyroid nodule.Abstract:
Replacing palpating fingers with an ultrasound (US) probe has resulted in an epidemic of thyroid nodules. Despite the high prevalence of thyroid nodules in the general population, thyroid malignancy is rare. Although no imaging modality can accurately predict the nature of every nodule, high-resolution US is the most sensitive, easily available and cost-effective diagnostic test available to detect thyroid nodules, measure their dimensions and identify their structure. The presence of calcifications, irregular spiculated outline, hypoechogenicity in a solid nodule, chaotic intranodular vascularity and an elongated shape are well-known US features of malignancy in thyroid nodules. Cervical lymph node metastasis and extrathyroidal extension of a thyroid nodule are highly specific for malignancy but seen infrequently. Spongiform nodules, purely or predominantly cystic nodules, nodules with well-defined hypoechoic halo and echogenic as well as isoechoic nodules are usually benign. None of the US characteristics have 100% accuracy in detecting or excluding malignancy. Fine-needle biopsy is currently the best triage test for pre-operative evaluation of a thyroid nodule. There is no significant difference in the risk for malignancy between palpable and non-palpable nodules and size is not a reliable indicator for their malignant potential. The best tool for risk stratification for malignancy in thyroid nodules is US and guided biopsy of nodules with suspicious imaging features. This is especially relevant in patients with multinodular goitre.read more
Citations
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Journal ArticleDOI
Automated detection and classification of thyroid nodules in ultrasound images using clinical-knowledge-guided convolutional neural networks
Tianjiao Liu,Tianjiao Liu,Qianqian Guo,Chunfeng Lian,Xuhua Ren,Shujun Liang,Jing Yu,Lijuan Niu,Weidong Sun,Dinggang Shen,Dinggang Shen +10 more
TL;DR: This study proposes a novel deep-learning-based CAD system, guided by task-specific prior knowledge, for automated nodule detection and classification in ultrasound images, and demonstrates that the proposed method is effective in the discrimination of thyroid nodules.
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2020 Chinese guidelines for ultrasound malignancy risk stratification of thyroid nodules: the C-TIRADS.
JianQiao Zhou,LiXue Yin,Xi Wei,Sheng Zhang,YanYan Song,Baoming Luo,Jianchu Li,Linxue Qian,Li-Gang Cui,Wen Chen,Chaoyang Wen,Yu-Lan Peng,Qin Chen,Man Lu,Min Chen,Rong Wu,Wei Zhou,En-Sheng Xue,Ying-Jia Li,LiChun Yang,ChengRong Mi,RuiFang Zhang,Gang Wu,Guoqing Du,DaoZhong Huang,Weiwei Zhan,Superficial Organ,Breast Ultrasound +27 more
TL;DR: The Chinese-TIRADS that is in line with China’s national conditions and medical status was established based on literature review, expert consensus, and multicenter data provided by the Chinese Artificial Intelligence Alliance for Thyroid and Breast Ultrasound.
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Balancing the benefits and harms of thyroid cancer surveillance in survivors of Childhood, adolescent and young adult cancer: Recommendations from the international Late Effects of Childhood Cancer Guideline Harmonization Group in collaboration with the PanCareSurFup Consortium
Sarah C Clement,Sarah C Clement,Leontien C. M. Kremer,Frederik A. Verburg,Jill H. Simmons,M. Goldfarb,Robin P. Peeters,Erik K. Alexander,Edit Bardi,E. Brignardello,Louis S. Constine,Catherine A. Dinauer,Valentina Drozd,F. Felicetti,Eva Frey,A. Heinzel,M.M. van den Heuvel-Eibrink,S. A. Huang,Thera P. Links,Kerstin Lorenz,Renée L. Mulder,S.J.C.M.M. Neggers,E.J.M. Nieveen van Dijkum,Kevin C. Oeffinger,R.R. van Rijn,Scott A. Rivkees,Cécile M. Ronckers,Arthur B. Schneider,Roderick Skinner,J. D. Wasserman,T. Wynn,Melissa M. Hudson,Paul C. Nathan,H. M. van Santen +33 more
TL;DR: Of the two available surveillance strategies, thyroid ultrasound and neck palpation, neither was shown to be superior and the recommendations highlight the need for shared decision making regarding whether to undergo surveillance for DTC and in the choice of surveillance modality.
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Ultrasonography of thyroid nodules: a pictorial review.
TL;DR: A complete series of sonographic images are provided to illustrate benign and malignant features of thyroid nodules according to the U1–5 classification to assist radiologists and clinicians in recognising sonographic patterns of benign, suspicious andmalignant nodules based on U1-5 criteria, and in planning for further investigations.
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Contrast-Enhanced Ultrasound for Differentiation of Benign and Malignant Thyroid Lesions: Meta-analysis
Dongmei Yu,Yuna Han,Taotao Chen +2 more
TL;DR: Contrast-enhanced ultrasound is a promising noninvasive technique for the differential diagnosis of benign and malignant thyroid nodules and could be a valuable supplemental method to fine-needle aspiration.
References
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2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer: The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer.
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