Ultrasound Risk Stratification System of Thyroid Nodule

Abstract

Thyroid nodules are a common medical concern with an increasing prevalence due largely to the widespread use of ultrasonography (US). US is the primary diagnostic tool for identifying thyroid nodules, determining their size and characteristics, guiding fine-needle aspiration (FNA), and diagnosing lymph node metastasis. The most consistent US features indicating a malignancy in thyroid nodules include spiculated margins, microcalcifications, a taller-than-wide shape, and pronounced hypoechogenicity. Based on these imaging findings, clinicians must determine which nodules require further evaluation and which can be monitored over time. Despite the central role of thyroid US in managing these nodules, there is no clear consensus regarding which nodules should undergo US-guided FNA, nor is there a standardized terminology for describing the US features. Consequently, medical societies recommend using US risk stratification systems to standardize reporting and simplify clinical decision-making. This review aims to provide a comprehensive overview of the various US risk stratification systems employed for thyroid nodules, allowing readers to gain a better understanding of how nodules are assessed using these different systems. Furthermore, this study examines the efficacy, weaknesses, and potential pitfalls of these US risk stratification systems and discusses future perspectives for their optimal clinical application in managing thyroid nodules.

Keywords

• ultrasonography
• risk
• thyroid nodule