Classification system of ultrasound patterns of non-nodular thyroid diseases

PURPOSE: Thyroid disorders are largely present in the general population. In addition to the medical history and laboratory tests, ultrasound (US) is a sensitive method for assessing thyroid diseases. Since thyroid nodules (TNs) are significantly more prevalent than non-nodular diseases – i.e., autoimmune, inflammatory, etc. – and entirely normal thyroid pattern, the largest part of the specific literature has been focused on TN. Indeed, international societies have developed systems to stratify the cancer risk of TN (i.e., TIRADS) while no classification exists to assess non-nodular disorders. METHODS: A three-score US-based classification of thyroid parenchyma is proposed: (1) pattern “N” – normal parenchyma, (2) pattern “A” – autoimmune - to assess autoimmune disease; (3) pattern “I” – inflammation - to assess thyroid inflammation/infection diseases. RESULTS AND CONCLUSIONS: Such a system could (1) cover the current lack of standardized classification of parenchyma, (2) improve the accuracy of US operators, and (3) facilitate the exchange among thyroidologists (endocrinologists as first) and stakeholders.