Thyroid ultrasound and its ancillary techniques.

Area of Science:

• Radiology
• Medical Imaging
• Oncology

Background:

• Ultrasound (US) has been a primary diagnostic tool for thyroid disease since the late 1960s.
• While effective for many conditions, characterizing thyroid nodules with US remains challenging.
• Thyroid Imaging Reporting and Data Systems (TIRADSs) have improved thyroid cancer diagnosis.

Purpose of the Study:

• To review the evolving role of ultrasound in thyroid disease diagnosis and management.
• To highlight advancements in US techniques and the integration of artificial intelligence (AI).
• To discuss emerging interventional ultrasound therapies for thyroid conditions.

Main Methods:

• Review of current literature on thyroid ultrasound applications.
• Discussion of established and novel US techniques including elastography, superb microvascular imaging (SMI), contrast-enhanced ultrasound (CEUS), and multiparametric ultrasound (MPUS).
• Exploration of artificial intelligence (AI) in thyroid nodule characterization and the potential of fine-needle biopsy (FNB) and molecular markers.

Main Results:

• US, combined with clinical and hormonal data, often provides sufficient diagnosis for thyroid disease.
• TIRADSs have significantly improved the diagnostic accuracy for thyroid cancer.
• Newer US techniques (elastography, SMI, CEUS, MPUS) and AI show promise in enhancing nodule characterization and diagnostic performance, potentially exceeding human capabilities.

Conclusions:

• The combination of advanced US techniques, AI, FNB, and molecular markers may lead to a new era of diagnostic accuracy for thyroid diseases.
• Interventional ultrasound, specifically US-guided thermal ablation (TA), is emerging as a viable therapeutic option for both benign and malignant thyroid diseases.