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Thyroid ultrasound consensus statement aims to standardize reports
An interdisciplinary consensus statement released by the Thyroid, Head and Neck Cancer Foundation aims to standardize ultrasound characterization features and a system for tracking sequential changes.
Nine specialists from disciplines involved in the diagnosis and treatment of thyroid cancer agreed upon protocol for ultrasound evaluation for thyroid gland and nodules and cervical lymph nodes, and ultrasound-guided fine-needle aspiration of thyroid nodules and cervical lymph nodes.
“The standardization of [ultrasound] examination reporting in a manner consistent with current schemes of risk stratification based on [ultrasound] features promises to enhance patient care by facilitating the diagnosis and long-term surveillance of thyroid nodules and thyroid cancer,” the researchers wrote.
Convened in September with subsequent meetings in October, the panel consisted of experts from otolaryngology/head and neck surgery, endocrine surgery, endocrinology, radiology and cytopathology; phone and email communication helped the scientists fine-tune the guidelines.
Once a neck ultrasound is performed, the consensus recommends the purpose and overall impression be documented. At minimum, the presence and size of each thyroid lobe and isthmus should be part of the initial characterization, along with vascularity and the echogenicity and any calcification patterns within the thyroid gland, according to the statement.
The consensus also recommends the presence of a pyramidal lobe, extension of the thyroid into the mediastinum, tracheal deviation and the presence of a thyroglossal duct cyst and other atypical anatomic findings be characterized and documented, if observed.
Specialists should also initially note an overall impression of disease status of the entire thyroid, according to the statement.
The consensus highlights the variability among specialties in defining dimensions of the thyroid gland, nodules and lymph nodes — anteroposterior, transverse and longitudinal measurements — and recommends reports specify order and maintain consistency to avoid ambiguity and solidify a system of measurement for the future.
Five features of an electronic reporting system were also spelled out by the panel in the consensus to address workflow integration and efficiency; its focus is on ease, automation, billing, capturing and reviewing data and queries for clinical research.
The recommendations made by the panel aim to augment several international practice guidelines, including those set forth by the American Association of Clinical Endocrinologists, to achieve greater detail in reporting to ultimately improve risk stratification, according to the statement.
“Standardization of [ultrasound] reporting is intended to facilitate consistent and clear communication among the various physicians involved in the management of patients with thyroid nodules and thyroid cancer,” the researchers wrote. “Thus, it is important to determine the minimum necessary comprehensive data set in a multidisciplinary forum to best reflect the essential elements that are deemed to be important by each specialty.”
For more information, visit www.thancfoundation.org.