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Risk Stratification of Thyroid Nodules: From Ultrasound Features to TIRADS.
1Department of Clinical and Experimental Medicine, Endocrinology Section, University of Pisa, 56124 Pisa, Italy.
Cancers
|February 15, 2022
Summary
High-resolution ultrasonography (US) aids in detecting thyroid nodules and assessing malignancy risk. Features like spiculated margins and microcalcifications suggest cancer, while elastosonography (USE) indicating low elasticity also raises concern.
Area of Science:
- Radiology
- Endocrinology
- Oncology
Background:
- Thyroid nodules are common, particularly in iodine-deficient areas, females, and post-irradiation.
- High-resolution ultrasonography (US) is crucial for thyroid nodule detection and evaluation.
- Neck lymph node metastasis assessment is also facilitated by US.
Purpose of the Study:
- To outline the role of ultrasonography (US) in detecting and evaluating thyroid nodules.
- To identify key US features indicative of thyroid nodule malignancy.
- To discuss the utility of thyroid elastosonography (USE) in risk stratification.
Main Methods:
- High-resolution ultrasonography (US) for nodule size, features, and lymph node metastasis.
- Identification of consistent US malignancy features: spiculated margins, microcalcifications, taller-than-wide shape, marked hypoechogenicity.
- Thyroid elastosonography (USE) to assess nodule elasticity.
Main Results:
- Spiculated margins, microcalcifications, taller-than-wide shape, and marked hypoechogenicity are key US indicators of malignancy.
- Increased nodular vascularization is not a reliable predictor of malignancy.
- Low elasticity on USE correlates with a higher risk of malignancy.
Conclusions:
- Thyroid nodules can be risk-stratified into low, intermediate, and high categories based on US features.
- US-FNA is recommended for intermediate and high-risk nodules.
- US and USE are valuable tools for thyroid nodule characterization and guiding further management.
