Thyroid No surgery 101: Diagnostic Ultrasound in Small 1 cm Benign and Micro-Papillary Cancers
Comments: We use taller than wide calcifications and blood flow as criteria for suspicious nodules but tend to avoid biopsies ion small nodules because it leads to excessive surgery and more complications without increased survival. Avoid non-indicated ultrasounds or biopsies on <1 cm nodules.
Call Matt at 310-393-8860 for an opinion if you need a biopsy or if you have indications for the ultrasound or email email@example.com
No screening thyroid ultrasounds.No biopsies on <1 cm nodules without ultrasound evidence of suspicious findings.
Richard Guttler MD,FACE,ECNU
- 160 cases of confirmed benign thyroid nodules and 150 cases of PTMCs.
- Ultrasound findings of shape, margin, calcification, and vascularity.
- An ovoid-to-round regular shape, rim calcification, and no intrinsic blood flow were the statistically significant features for the depiction of a benign degenerating cystic nodule.
- While a taller-than-wide shape and peripheral or intranodular blood flow were that of a malignancy.
- Each of them as an independent predictor of malignancy (P < 0.05).
- Shape, rim calcification, and vascularity are efficient criteria to distinguish degenerating cystic thyroid nodules mimicking malignancy from PTMCs in cases of solid hypoechogenic nodules under 10 mm.
- Such criteria should be acknowledged in cases of solid hypoechogenic thyroid nodules to help guide for the need of US-FNA.