Clinical applications of Doppler ultrasonography for thyroid disease: consensus statement by the Korean Society of Thyroid Radiology

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Abstract

Doppler ultrasonography (US) is widely used for the differential diagnosis of thyroid nodules, metastatic cervical lymph nodes in patients with thyroid cancer, and diffuse parenchymal disease, as well as for guidance in various US-guided procedures, including biopsy and ablation. However, controversies remain regarding the appropriate use and interpretation of Doppler US. Therefore, the Korean Society of Thyroid Radiology organized a taskforce to develop a consensus statement on the clinical use of Doppler US for thyroid disease. The review and recommendations in this article are based on a comprehensive analysis of the current literature and the consensus of experts.

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Most cited references 99

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Thyroiditis.

Elizabeth N Pearce, Alan P Farwell, Lewis Braverman (2003)

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The EFSUMB Guidelines and Recommendations for the Clinical Practice of Contrast-Enhanced Ultrasound (CEUS) in Non-Hepatic Applications: Update 2017 (Long Version).

Paul S Sidhu, Vito Cantisani, Christoph F Dietrich … (2018)

The updated version of the EFSUMB guidelines on the application of non-hepatic contrast-enhanced ultrasound (CEUS) deals with the use of microbubble ultrasound contrast outside the liver in the many established and emerging applications.

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Risk of malignancy in nonpalpable thyroid nodules: predictive value of ultrasound and color-Doppler features.

Enrico Papini, Rinaldo Guglielmi, Antonio Bianchini … (2002)

The aim of the study was to correlate the sonographic [ultrasound (US)] and color-Doppler (CFD) findings with the results of US-guided fine needle aspiration biopsy (FNA) and of pathologic staging of resected carcinomas to establish: 1) the relative importance of US features as risk factors of malignancy; and 2) a cost-effective management of nonpalpable thyroid nodules. Four hundred ninety-four consecutive patients with nonpalpable thyroid nodules (8-15 mm) were evaluated by US, CFD, and US-FNA. Ninety-two patients with inadequate cytology were excluded from the study. All patients with suspicious or malignant cytology underwent surgery, whereas subjects with benign cytology had clinical and US control 6 months later. Thyroid malignancies were observed in 18 of 195 (9.2%) solitary thyroid nodules and in 13 of 207 (6.3%) multinodular goiters. Cancer prevalence was similar in nodules greater or smaller than 10 mm (9.1 vs. 7.0%). Extracapsular growth (pT(4)) was present in 35.5%, and nodal involvement in 19.4% of neoplastic lesions, with no significant differences between tumors greater or smaller than 10 mm. At US cancers presented a solid hypoechoic appearance in 87% of cases, irregular or blurred margins in 77.4%, an intranodular vascular pattern in 74.2%, and microcalcifications in 29.0%. Irregular margins (RR 16.83), intranodular vascular spots (RR 14.29), and microcalcifications (RR 4.97) were independent risk factors of malignancy. FNA performed on hypoechoic nodules with at least one risk factor was able to identify 87% of the cancers at the expence of cytological evaluation of 38.4% of nonpalpable lesions. The majority of nonpalpable thyroid tumors can be identified by cytological evaluation of lesions presenting hypoechoic appearance in conjunction with one independent risk factor. Due to the nonnegligible prevalence of extracapsular growth and nodal metastasis, US-FNA should be performed on all 8-15 mm hypoechoic nodules with irregular margins, intranodular vascular spots or microcalcifications. Nonpalpable lesions of the thyroid without risk factors should be followed by means of clinical and US evaluation.

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Author and article information

Journal

Journal ID (nlm-ta): Ultrasonography

Journal ID (iso-abbrev): Ultrasonography

Journal ID (publisher-id): USG

Title: Ultrasonography

Publisher: Korean Society of Ultrasound in Medicine

ISSN (Print): 2288-5919

ISSN (Electronic): 2288-5943

Publication date (Print): October 2020

Publication date (Electronic): 25 August 2020

Volume: 39

Issue: 4

Pages: 315-330

Affiliations

[1 ]Department of Radiology, Ewha Womans University College of Medicine, Seoul, Korea

[2 ]Department of Radiology, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea

[3 ]Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea

[4 ]Department of Radiology, Ajou University School of Medicine, Suwon, Korea

[5 ]Division for Healthcare Technology Assessment Research, National Evidence-based Healthcare Collaborating Agency, Seoul, Korea

[6 ]Department of Radiology, GangNeung Asan Hospital, Gangneung, Korea

[7 ]Human Medical Imaging and Intervention Center, Seoul, Korea

Author notes

Correspondence to: Young Jun Choi, MD, PhD, Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Korea Tel. +82-2-3010-4400 Fax. +82-2-476-0090 E-mail: jehee23@ 123456gmail.com

[*]

These authors contributed equally to this work.

Author information

Jin Chung http://orcid.org/0000-0001-9990-3768

Yoo Jin Lee http://orcid.org/0000-0003-4701-7339

Young Jun Choi http://orcid.org/0000-0001-7098-5042

Eun Ju Ha http://orcid.org/0000-0002-1234-2919

Chong Hyun Suh http://orcid.org/0000-0002-4737-0530

Miyoung Choi http://orcid.org/0000-0002-2424-9965

Jung Hwan Baek http://orcid.org/0000-0003-0480-4754

Dong Gyu Na http://orcid.org/0000-0001-6422-1652

Article

Publisher ID: usg-20072

DOI: 10.14366/usg.20072

PMC ID: 7515666

PubMed ID: 32892523

SO-VID: d0441a69-61be-4588-8f57-66f0fa5b7015

License:

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

History

Date received : 22 May 2020

Date revision received : 24 August 2020

Date accepted : 25 August 2020

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Clinical applications of Doppler ultrasonography for thyroid disease: consensus statement by the Korean Society of Thyroid Radiology

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Bioscientifica Open Endocrinology

Most cited references 99

Thyroiditis.

The EFSUMB Guidelines and Recommendations for the Clinical Practice of Contrast-Enhanced Ultrasound (CEUS) in Non-Hepatic Applications: Update 2017 (Long Version).

Risk of malignancy in nonpalpable thyroid nodules: predictive value of ultrasound and color-Doppler features.

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