ESR Essentials: thyroid imaging-practice recommendations by the European Society of Head and Neck Radiology

Area of Science:

• Radiology
• Endocrinology
• Pathology

Background:

• Thyroid nodules are common, but most are benign, posing a diagnostic challenge to differentiate them from malignant ones.
• Unnecessary biopsies, patient anxiety, and overtreatment are significant concerns in managing thyroid nodules.
• Ultrasound (US) is the primary imaging tool for thyroid nodule evaluation.

Purpose of the Study:

• To outline the role of ultrasound and risk stratification systems in managing thyroid nodules.
• To emphasize the importance of a multidisciplinary approach in thyroid cancer care.
• To promote standardized reporting and evidence-based criteria for radiologists in thyroid nodule assessment.

Main Methods:

• Utilizing structured risk stratification systems like ACR TI-RADS and EU-TIRADS based on sonographic features.
• Employing ultrasound for diffuse thyroid disorders assessment alongside thyroid function tests.
• Highlighting the necessity of a multidisciplinary team for thyroid cancer management.

Main Results:

• Most thyroid nodules are benign and do not require intervention.
• Suspicious sonographic features (e.g., irregular margins, microcalcifications) warrant further investigation like fine-needle aspiration (FNA).
• Standardized US reporting and evidence-based criteria reduce unnecessary procedures and improve patient care.

Conclusions:

• Ultrasound, guided by TI-RADS, is essential for effective thyroid nodule management.
• A collaborative, multidisciplinary approach is crucial for optimal thyroid cancer patient care.
• Radiologists adopting standardized reporting and evidence-based criteria ensure high-value, patient-centered care.