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Thyroid nodules: risk stratification for malignancy with ultrasound and guided biopsy

Replacing palpating fingers with an ultrasound (US) probe has resulted in an epidemic of thyroid nodules. Despite the high prevalence of thyroid nodules in the general population, thyroid malignancy is rare. Although no imaging modality can accurately predict the nature of every nodule, high-resolut...

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Autores principales: Anil, Gopinathan, Hegde, Amogh, Chong, F.H. Vincent
Formato: Online Artículo Texto
Lenguaje:English
Publicado: e-Med 2011
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3266587/
https://www.ncbi.nlm.nih.gov/pubmed/22203727
http://dx.doi.org/10.1102/1470-7330.2011.0030
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author Anil, Gopinathan
Hegde, Amogh
Chong, F.H. Vincent
author_facet Anil, Gopinathan
Hegde, Amogh
Chong, F.H. Vincent
author_sort Anil, Gopinathan
collection PubMed
description Replacing palpating fingers with an ultrasound (US) probe has resulted in an epidemic of thyroid nodules. Despite the high prevalence of thyroid nodules in the general population, thyroid malignancy is rare. Although no imaging modality can accurately predict the nature of every nodule, high-resolution US is the most sensitive, easily available and cost-effective diagnostic test available to detect thyroid nodules, measure their dimensions and identify their structure. The presence of calcifications, irregular spiculated outline, hypoechogenicity in a solid nodule, chaotic intranodular vascularity and an elongated shape are well-known US features of malignancy in thyroid nodules. Cervical lymph node metastasis and extrathyroidal extension of a thyroid nodule are highly specific for malignancy but seen infrequently. Spongiform nodules, purely or predominantly cystic nodules, nodules with well-defined hypoechoic halo and echogenic as well as isoechoic nodules are usually benign. None of the US characteristics have 100% accuracy in detecting or excluding malignancy. Fine-needle biopsy is currently the best triage test for pre-operative evaluation of a thyroid nodule. There is no significant difference in the risk for malignancy between palpable and non-palpable nodules and size is not a reliable indicator for their malignant potential. The best tool for risk stratification for malignancy in thyroid nodules is US and guided biopsy of nodules with suspicious imaging features. This is especially relevant in patients with multinodular goitre.
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spelling pubmed-32665872013-12-28 Thyroid nodules: risk stratification for malignancy with ultrasound and guided biopsy Anil, Gopinathan Hegde, Amogh Chong, F.H. Vincent Cancer Imaging Review Replacing palpating fingers with an ultrasound (US) probe has resulted in an epidemic of thyroid nodules. Despite the high prevalence of thyroid nodules in the general population, thyroid malignancy is rare. Although no imaging modality can accurately predict the nature of every nodule, high-resolution US is the most sensitive, easily available and cost-effective diagnostic test available to detect thyroid nodules, measure their dimensions and identify their structure. The presence of calcifications, irregular spiculated outline, hypoechogenicity in a solid nodule, chaotic intranodular vascularity and an elongated shape are well-known US features of malignancy in thyroid nodules. Cervical lymph node metastasis and extrathyroidal extension of a thyroid nodule are highly specific for malignancy but seen infrequently. Spongiform nodules, purely or predominantly cystic nodules, nodules with well-defined hypoechoic halo and echogenic as well as isoechoic nodules are usually benign. None of the US characteristics have 100% accuracy in detecting or excluding malignancy. Fine-needle biopsy is currently the best triage test for pre-operative evaluation of a thyroid nodule. There is no significant difference in the risk for malignancy between palpable and non-palpable nodules and size is not a reliable indicator for their malignant potential. The best tool for risk stratification for malignancy in thyroid nodules is US and guided biopsy of nodules with suspicious imaging features. This is especially relevant in patients with multinodular goitre. e-Med 2011-12-28 /pmc/articles/PMC3266587/ /pubmed/22203727 http://dx.doi.org/10.1102/1470-7330.2011.0030 Text en © 2011 International Cancer Imaging Society
spellingShingle Review
Anil, Gopinathan
Hegde, Amogh
Chong, F.H. Vincent
Thyroid nodules: risk stratification for malignancy with ultrasound and guided biopsy
title Thyroid nodules: risk stratification for malignancy with ultrasound and guided biopsy
title_full Thyroid nodules: risk stratification for malignancy with ultrasound and guided biopsy
title_fullStr Thyroid nodules: risk stratification for malignancy with ultrasound and guided biopsy
title_full_unstemmed Thyroid nodules: risk stratification for malignancy with ultrasound and guided biopsy
title_short Thyroid nodules: risk stratification for malignancy with ultrasound and guided biopsy
title_sort thyroid nodules: risk stratification for malignancy with ultrasound and guided biopsy
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3266587/
https://www.ncbi.nlm.nih.gov/pubmed/22203727
http://dx.doi.org/10.1102/1470-7330.2011.0030
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