TY - JOUR
T1 - Thyroid nodule evaluation
T2 - what have we really learned from recent clinical guidelines?
AU - Carpi, A.
AU - Mechanick, J. I.
AU - Nicolini, A.
AU - Rubello, D.
AU - Iervasi, G.
AU - Bonazzi, V.
AU - Giardino, R.
PY - 2006/9
Y1 - 2006/9
N2 - Recent guidelines for the evaluation of thyroid nodules clarify the diagnostic algorithm while also reporting important differences. The performance of fine needle aspiration (FNA) for cytological examination follows serum TSH determination and thyroid ultrasonography. Thyroid scintigraphy is recommended following a low TSH value and/or FNA yielding an indeterminate follicular cytology. The use of thyroid ultrasonography is the source of some controversy: though it is recommended as a principal first test, its real-time use to guide FNA ranges from routine to only following an FNA yielding an inadequate or nondiagnostic cytological result. In clinical practice, the proportion of physicians utilizing ultrasonography, scintigraphy and FNA varies and frequently deviates from recommended guidelines. The development of guidelines is necessary to bring about consistency and optimization to the diagnostic work-up of thyroid nodules. It is likely that novel diagnostic procedures, such as molecular markers, large needle aspiration biopsy and thyroid imaging with tracers beyond conventional radioactive iodine or 99mTc pertechnetate, will lead to improved performance and implementation of guidelines.
AB - Recent guidelines for the evaluation of thyroid nodules clarify the diagnostic algorithm while also reporting important differences. The performance of fine needle aspiration (FNA) for cytological examination follows serum TSH determination and thyroid ultrasonography. Thyroid scintigraphy is recommended following a low TSH value and/or FNA yielding an indeterminate follicular cytology. The use of thyroid ultrasonography is the source of some controversy: though it is recommended as a principal first test, its real-time use to guide FNA ranges from routine to only following an FNA yielding an inadequate or nondiagnostic cytological result. In clinical practice, the proportion of physicians utilizing ultrasonography, scintigraphy and FNA varies and frequently deviates from recommended guidelines. The development of guidelines is necessary to bring about consistency and optimization to the diagnostic work-up of thyroid nodules. It is likely that novel diagnostic procedures, such as molecular markers, large needle aspiration biopsy and thyroid imaging with tracers beyond conventional radioactive iodine or 99mTc pertechnetate, will lead to improved performance and implementation of guidelines.
KW - Fine needle aspiration (FNA)
KW - Thyroid nodule evaluation
KW - Ultrasonography
UR - http://www.scopus.com/inward/record.url?scp=33748913787&partnerID=8YFLogxK
U2 - 10.1016/j.biopha.2006.07.005
DO - 10.1016/j.biopha.2006.07.005
M3 - Short survey
C2 - 16905290
AN - SCOPUS:33748913787
SN - 0753-3322
VL - 60
SP - 393
EP - 395
JO - Biomedicine and Pharmacotherapy
JF - Biomedicine and Pharmacotherapy
IS - 8
ER -