Contemporary Management of Thyroid Nodules

Area of Science:

• Endocrinology
• Radiology
• Pathology

Background:

• Thyroid nodules are highly prevalent, particularly in women and older individuals.
• Malignant thyroid nodules, predominantly papillary thyroid cancer, account for about 5% of cases.
• Ultrasonography is crucial for evaluating thyroid nodules and lymph nodes.

Purpose of the Study:

• To outline the diagnostic and risk stratification process for thyroid nodules.
• To explain the role of ultrasonography, fine-needle aspiration biopsy, and molecular testing.

Main Methods:

• Utilizing ultrasonography to characterize nodule features and assess lymphadenopathy.
• Employing fine-needle aspiration biopsy based on ultrasound findings and clinical history.
• Classifying cytology results using the Bethesda system and applying molecular testing for indeterminate cases.

Main Results:

• Ultrasonography guides nodule selection for biopsy and risk stratification.
• The Bethesda system categorizes thyroid nodule cytology from benign to malignant.
• Molecular testing refines risk assessment for indeterminate cytology, informing management decisions.

Conclusions:

• A multi-modal approach including imaging, biopsy, and molecular testing optimizes thyroid nodule management.
• Surveillance is recommended for benign or low-risk indeterminate nodules.
• Accurate risk stratification ensures appropriate patient care pathways for thyroid nodules.