The Diagnosis and Management of Thyroid Nodules: A Review

@article{Durante2018TheDA,
  title={The Diagnosis and Management of Thyroid Nodules: A Review},
  author={Cosimo Durante and Giorgio Grani and Livia Lamartina and Sebastiano Filetti and Susan J. Mandel and David S. Cooper},
  journal={JAMA},
  year={2018},
  volume={319},
  pages={914–924}
}
Importance Thyroid nodules are common, being detected in up to 65% of the general population. [...] Key Result Additional diagnostic procedures, such as molecular testing, are indicated only in selected cases, such as indeterminate cytology (≈20%-30% of all biopsies). The initial risk estimate, derived from ultrasound and, if performed, cytology report, should determine the need for treatment and the type, frequency, and length of subsequent follow-up.Expand
The Evaluation and Management of Thyroid Nodules
TLDR
The challenge clinicians face, as increasingly more nodules are being identified, is to determine which nodsules are clinically significant, specifically those which will require intervention due to high risk of malignancy or large size with compressive symptoms. Expand
Contemporary Thyroid Nodule Evaluation and Management
TLDR
Thyroid nodule evaluation is no longer a 1-size-fits-all proposition, and for most nodules, the likelihood of malignancy can be confidently estimated without resorting to cytology or molecular testing, and low-frequency surveillance is sufficient for most patients. Expand
Update on the Evaluation of Thyroid Nodules.
  • V. Bernet, A. Chindris
  • Medicine
  • Journal of nuclear medicine : official publication, Society of Nuclear Medicine
  • 2021
TLDR
The increase in frequency of imaging has led to a rise in the incidence of incidentally diagnosed TN and the indications for biopsy and frequency of Imaging should be tailored on the basis of risk stratification. Expand
Thyroid Nodules: Advances in Evaluation and Management.
TLDR
Treatment of pregnant women with nonfunctioning thyroid nodules and of children with Thyroid nodules is similar to that for nonpregnant adults, with the exception of molecular testing, which has not been validated in these populations. Expand
The role of fine-needle aspiration biopsy and post-operative histology in the evaluation of thyroid nodules
Thyroid nodules present a serious problem, and mostly they do not carry neoplastic characteristics. Thus, they do not need to be surgically treated. The risk of malignancy varies from 5 to 15 %.Expand
Reducing the Number of Unnecessary Thyroid Biopsies While Improving Diagnostic Accuracy: Toward the “Right” TIRADS
TLDR
Internationally endorsed sonographic risk stratification systems vary widely in their ability to reduce the number of unnecessary thyroid nodule FNAs. Expand
Systems of Risk Stratification of Malignancy by Ultrasound of Thyroid Nodules
TLDR
The different systems developed by some scientific societies for the stratification of thyroid nodules are compared with respect to their predictive capacities for malignancy, their operational characteristics for diagnosis, and, to suggest recommendations for the implementation of these systems. Expand
The Combination of Sonographic Features and the Seven-Gene Panel May be Useful in the Management of Thyroid Nodules With Indeterminate Cytology
TLDR
US score seems able to correctly discriminate between TIR3A nodules in which a conservative approach may be used, and those in which additional test, such as molecular test, may be indicated, because the risk of thyroid cancer remains high regardless of US score and mutational status. Expand
THYROID NODULE LOCATION ON ULTRASONOGRAPHY AS A PREDICTOR OF MALIGNANCY.
  • F. Zhang, O. Oluwo, +5 authors T. Zahedi
  • Medicine
  • Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists
  • 2019
TLDR
This study is the first showing that thyroid nodules located in the upper pole can be considered as having higher risk for malignancy, and it may enhance the predictive value of malignancies if it is included in thyroid nodule ultrasound classification guidelines. Expand
Management of thyroid nodules in adults
TLDR
Thyroid nodule is an abnormal growth of thyroid cells that form a lump in the thyroid gland that may be either single or multiple and the majority are asymptomatic and benign in nature. Expand
...
1
2
3
4
5
...

References

SHOWING 1-10 OF 88 REFERENCES
Nonsurgical approaches to the management of thyroid nodules
TLDR
Radioiodine is the therapy of choice for toxic nodules or for symptomatic nodular goiters when surgery is not possible, and percutaneous ethanol injection should be used as the first-line therapy only for recurrent symptomatic cystic nodules. Expand
The natural history of benign thyroid nodules.
TLDR
Among patients with asymptomatic, sonographically or cytologically benign thyroid nodules, the majority of nodules exhibited no significant size increase during 5 years of follow-up and thyroid cancer was rare, and these findings support consideration of revision of current guideline recommendations for follow-ups. Expand
Preoperative diagnosis of benign thyroid nodules with indeterminate cytology.
TLDR
Consideration of a more conservative approach for most patients with thyroid nodules that are cytologically indeterminate on fine-needle aspiration and benign according to gene-expression classifier results are suggested. Expand
Evaluation of a thyroid nodule.
TLDR
Detecting malignancy preoperatively allows total thyroidectomy in a single operation without the need for frozen section or a second operation for completion of a thyroidectomy if malignancies is found during the initial thyroid lobectomy. Expand
Long- versus short-interval follow-up of cytologically benign thyroid nodules: a prospective cohort study
TLDR
While expert opinion currently recommends repeat evaluation of a cytologically benign nodule at 1–2 years, these are the first data to demonstrate that this interval can be safely extended to 3 years without increased mortality or patient harm. Expand
Benign and malignant thyroid nodules: US differentiation--multicenter retrospective study.
TLDR
Shape, margin, echogenicity, and presence of calcification are helpful criteria for the discrimination of malignant from benign nodules; the diagnostic accuracy of US criteria is dependent on tumor size. Expand
Value of US correlation of a thyroid nodule with initially benign cytologic results.
PURPOSE To investigate the value of ultrasonographic (US) features in thyroid nodules with initially benign cytologic results. MATERIALS AND METHODS The institutional review board approved thisExpand
Preoperative diagnosis of thyroid nodules using the Bethesda System for Reporting Thyroid Cytopathology: a comprehensive review and meta-analysis
TLDR
The BSRTC represents an important advance in standardizing thyroid FNAB cytopathological reporting and should be paid to the observation that the AUS-FLUS and FN-SFN DCs have overlapping ROMs, and the potential clinical implications on patient management. Expand
Thyroid Incidentalomas: Epidemiology, Risk Stratification with Ultrasound and Workup
TLDR
The diagnosis and workup of thyroid incidentalomas leads to superfluous surgery for benign conditions, and excess diagnosis and treatment of papillary microcarcinomas, the vast majority of which would cause no harm. Expand
Fine-Needle Aspiration Biopsy of Benign Thyroid Nodules: An Evidence-Based Review
TLDR
A successful FNAB service rests on several factors, and the importance of clinical conferences between all specialists involved in the diagnosis and treatment of patients with thyroid disorders cannot be overemphasized. Expand
...
1
2
3
4
5
...