EFSUMB Guidelines on Multiparametric Ultrasound Thyroid Nodule Evaluation: PART I

Area of Science:

• Radiology
• Oncology
• Endocrinology

Background:

• Thyroid nodules are common, but malignancy rates are low (4-6.5%), leading to frequent invasive diagnostic procedures and overtreatment.
• Current diagnostic methods for thyroid nodules are often costly, time-consuming, and can result in unnecessary interventions.

Purpose of the Study:

• To provide a guideline for the recognition and use of multiparametric ultrasound (MPUS) features in thyroid nodule characterization.
• To minimize unnecessary interventions and guide appropriate treatments for thyroid nodules through enhanced ultrasound evaluation.
• To stimulate the routine clinical practice adoption of MPUS for thyroid nodule assessment.

Main Methods:

• Review of published literature on multiparametric ultrasound for thyroid nodules.
• Expert consensus recommendations from the European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB).
• Analysis of MPUS applications in specific scenarios like indeterminate nodules, multinodular goiter, and lymph node staging.

Main Results:

• MPUS, incorporating technologies like Microvascular flow imaging, Elastosonography, contrast-enhanced ultrasound (CEUS), and artificial intelligence (AI), enhances thyroid nodule characterization.
• MPUS is valuable in guiding thyroid biopsy/aspiration and staging cervical lymph nodes.
• Evidence-based recommendations are provided for MPUS use in various thyroid nodule scenarios.

Conclusions:

• Multiparametric ultrasound evaluation is essential for accurate thyroid nodule characterization and management.
• Adoption of MPUS in routine clinical practice can significantly reduce unnecessary diagnostic procedures and overtreatment.
• This guideline aims to standardize and promote the effective use of MPUS in clinical settings for improved patient outcomes.