DOI QR코드

DOI QR Code

Standardized Imaging and Reporting for Thyroid Ultrasound: Korean Society of Thyroid Radiology Consensus Statement and Recommendation

  • Min Kyoung Lee (Department of Radiology, Yeoido St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Dong Gyu Na (Department of Radiology, Gangneung Asan Hospital, Ulsan University College of Medicine) ;
  • Leehi Joo (Department of Radiology, Korea University Guro Hospital) ;
  • Ji Ye Lee (Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine) ;
  • Eun Ju Ha (Department of Radiology, Ajou University Hospital, Ajou University School of Medicine) ;
  • Ji-Hoon Kim (Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine) ;
  • So Lyung Jung (Department of Radiology, Yeoido St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Jung Hwan Baek (Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center)
  • Received : 2022.11.14
  • Accepted : 2022.11.18
  • Published : 2023.01.01

Abstract

Ultrasonography (US) is a primary imaging modality for diagnosing nodular thyroid disease and has an essential role in identifying the most appropriate management strategy for patients with nodular thyroid disease. Standardized imaging techniques and reporting formats for thyroid US are necessary. For this purpose, the Korean Society of Thyroid Radiology (KSThR) organized a task force in June 2021 and developed recommendations for standardized imaging technique and reporting format, based on the 2021 KSThR consensus statement and recommendations for US-based diagnosis and management of thyroid nodules. The goal was to achieve an expert consensus applicable to clinical practice.

Keywords

Acknowledgement

This study was supported by a grant by 2020 Clinical Practice Guideline Research Fund by Korean Society of Radiology & Korean Society of Thyroid Radiology.

References

  1. Tunbridge WM, Evered DC, Hall R, Appleton D, Brewis M, Clark F, et al. The spectrum of thyroid disease in a community: the Whickham survey. Clin Endocrinol (Oxf) 1977;7:481-493  https://doi.org/10.1111/j.1365-2265.1977.tb01340.x
  2. Vander JB, Gaston EA, Dawber TR. The significance of nontoxic thyroid nodules. Final report of a 15-year study of the incidence of thyroid malignancy. Ann Intern Med 1968;69:537-540  https://doi.org/10.7326/0003-4819-69-3-537
  3. Brander A, Viikinkoski P, Nickels J, Kivisaari L. Thyroid gland: US screening in a random adult population. Radiology 1991;181:683-687  https://doi.org/10.1148/radiology.181.3.1947082
  4. Ezzat S, Sarti DA, Cain DR, Braunstein GD. Thyroid incidentalomas. Prevalence by palpation and ultrasonography. Arch Intern Med 1994;154:1838-1840  https://doi.org/10.1001/archinte.1994.00420160075010
  5. Tomimori E, Pedrinola F, Cavaliere H, Knobel M, Medeiros-Neto G. Prevalence of incidental thyroid disease in a relatively low iodine intake area. Thyroid 1995;5:273-276  https://doi.org/10.1089/thy.1995.5.273
  6. Gnarini VL, Brigante G, Della Valle E, Diazzi C, Madeo B, Carani C, et al. Very high prevalence of ultrasound thyroid scan abnormalities in healthy volunteers in Modena, Italy. J Endocrinol Invest 2013;36:722-728 
  7. Vaccarella S, Dal Maso L, Laversanne M, Bray F, Plummer M, Franceschi S. The impact of diagnostic changes on the rise in thyroid cancer incidence: a population-based study in selected high-resource countries. Thyroid 2015;25:1127-1136  https://doi.org/10.1089/thy.2015.0116
  8. Enewold L, Zhu K, Ron E, Marrogi AJ, Stojadinovic A, Peoples GE, et al. Rising thyroid cancer incidence in the United States by demographic and tumor characteristics, 1980-2005. Cancer Epidemiol Biomarkers Prev 2009;18:784-791  https://doi.org/10.1158/1055-9965.EPI-08-0960
  9. Lim H, Devesa SS, Sosa JA, Check D, Kitahara CM. Trends in thyroid cancer incidence and mortality in the United States, 1974-2013. JAMA 2017;317:1338-1348  https://doi.org/10.1001/jama.2017.2719
  10. Ahn HS, Welch HG. South Korea's thyroid-cancer "epidemic"-turning the tide. N Engl J Med 2015;373:2389-2390  https://doi.org/10.1056/NEJMc1507622
  11. Megwalu UC, Moon PK. Thyroid cancer incidence and mortality trends in the United States: 2000-2018. Thyroid 2022;32:560-570  https://doi.org/10.1089/thy.2021.0662
  12. Lee JY, Baek JH, Ha EJ, Sung JY, Shin JH, Kim JH, et al. 2020 imaging guidelines for thyroid nodules and differentiated thyroid cancer: Korean Society of Thyroid Radiology. Korean J Radiol 2021;22:840-860  https://doi.org/10.3348/kjr.2020.0578
  13. Ha EJ, Chung SR, Na DG, Ahn HS, Chung J, Lee JY, et al. 2021 Korean thyroid imaging reporting and data system and imaging-based management of thyroid nodules: Korean Society of Thyroid Radiology consensus statement and recommendations. Korean J Radiol 2021;22:2094-2123  https://doi.org/10.3348/kjr.2021.0713
  14. Ha EJ, Na DG, Baek JH. Korean thyroid imaging reporting and data system: current status, challenges, and future perspectives. Korean J Radiol 2021;22:1569-1578  https://doi.org/10.3348/kjr.2021.0106
  15. Haugen BR, Alexander EK, Bible KC, Doherty GM, Mandel SJ, Nikiforov YE, et al. 2015 American Thyroid Association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: the American Thyroid Association guidelines task force on thyroid nodules and differentiated thyroid cancer. Thyroid 2016;26:1-133  https://doi.org/10.1089/thy.2015.0020
  16. Moon WJ, Baek JH, Jung SL, Kim DW, Kim EK, Kim JY, et al. Ultrasonography and the ultrasound-based management of thyroid nodules: consensus statement and recommendations. Korean J Radiol 2011;12:1-14  https://doi.org/10.3348/kjr.2011.12.1.1
  17. Shin JH, Baek JH, Chung J, Ha EJ, Kim JH, Lee YH, et al. Ultrasonography diagnosis and imaging-based management of thyroid nodules: revised Korean Society of Thyroid Radiology consensus statement and recommendations. Korean J Radiol 2016;17:370-395  https://doi.org/10.3348/kjr.2016.17.3.370
  18. American Institute of Ultrasound in Medicine. AIUM practice guideline for the performance of thyroid and parathyroid ultrasound examination. J Ultrasound Med 2003;22:1126-1130  https://doi.org/10.7863/jum.2003.22.10.1126
  19. Yeh MW, Bauer AJ, Bernet VA, Ferris RL, Loevner LA, Mandel SJ, et al. American Thyroid Association statement on preoperative imaging for thyroid cancer surgery. Thyroid 2015;25:3-14  https://doi.org/10.1089/thy.2014.0096
  20. Chung J, Lee YJ, Choi YJ, Ha EJ, Suh CH, Choi M, et al. Clinical applications of Doppler ultrasonography for thyroid disease: consensus statement by the Korean Society of Thyroid Radiology. Ultrasonography 2020;39:315-330  https://doi.org/10.14366/usg.20072
  21. Amin MB, Edge SB, Greene FL, Byrd DR, Brookland RK, Washington MK, et al. AJCC cancer staging manual, 8th ed. New York: Springer International Publishing, 2017:59-60, 877-880 
  22. Carty SE, Cooper DS, Doherty GM, Duh QY, Kloos RT, Mandel SJ, et al. Consensus statement on the terminology and classification of central neck dissection for thyroid cancer. Thyroid 2009;19:1153-1158  https://doi.org/10.1089/thy.2009.0159
  23. Choi SH, Kim EK, Kim SJ, Kwak JY. Thyroid ultrasonography: pitfalls and techniques. Korean J Radiol 2014;15:267-276  https://doi.org/10.3348/kjr.2014.15.2.267
  24. Kim SY, Na DG, Paik W. Which ultrasound image plane is appropriate for evaluating the taller-than-wide sign in the risk stratification of thyroid nodules? Eur Radiol 2021;31:7605-7613  https://doi.org/10.1007/s00330-021-07936-4
  25. Desser TS, Kamaya A. Ultrasound of thyroid nodules. Neuroimaging Clin N Am 2008;18:463-478, vii  https://doi.org/10.1016/j.nic.2008.03.005
  26. Gritzmann N, Koischwitz D, Rettenbacher T. Sonography of the thyroid and parathyroid glands. Radiol Clin North Am 2000;38:1131-1145, xii  https://doi.org/10.1016/S0033-8389(05)70225-6
  27. Khati N, Adamson T, Johnson KS, Hill MC. Ultrasound of the thyroid and parathyroid glands. Ultrasound Q 2003;19:162-176  https://doi.org/10.1097/00013644-200312000-00002
  28. Nachiappan AC, Metwalli ZA, Hailey BS, Patel RA, Ostrowski ML, Wynne DM. The thyroid: review of imaging features and biopsy techniques with radiologic-pathologic correlation. Radiographics 2014;34:276-293  https://doi.org/10.1148/rg.342135067
  29. Aydiner O, Karakoc Aydiner E, Akpinar I, Turan S, Bereket A. Normative data of thyroid volume-ultrasonographic evaluation of 422 subjects aged 0-55 years. J Clin Res Pediatr Endocrinol 2015;7:98-101  https://doi.org/10.4274/jcrpe.1818
  30. Choi I, Na DG. Can the ultrasound echogenicity of normal parotid and submandibular glands be used as a reference standard for normal thyroid echogenicity? Ultrasonography 2022;41:678-688  https://doi.org/10.14366/usg.21254
  31. Ahn HS, Kim DW, Lee YJ, Baek HJ, Ryu JH. Diagnostic accuracy of real-time sonography in differentiating diffuse thyroid disease from normal thyroid parenchyma: a multicenter study. AJR Am J Roentgenol 2018;211:649-654  https://doi.org/10.2214/AJR.17.19164
  32. Baek HJ, Kim DW, Lee YJ, Ahn HS, Ryu JH. Comparison of real-time and static ultrasonography diagnoses for detecting incidental diffuse thyroid disease: a multicenter study. Ultrasound Q 2019;35:233-239  https://doi.org/10.1097/RUQ.0000000000000391
  33. Tessler FN, Middleton WD, Grant EG, Hoang JK, Berland LL, Teefey SA, et al. ACR thyroid imaging, reporting and data system (TI-RADS): white paper of the ACR TI-RADS committee. J Am Coll Radiol 2017;14:587-595  https://doi.org/10.1016/j.jacr.2017.01.046
  34. Sugitani I, Ito Y, Takeuchi D, Nakayama H, Masaki C, Shindo H, et al. Indications and strategy for active surveillance of adult low-risk papillary thyroid microcarcinoma: consensus statements from the Japan Association of Endocrine Surgery task force on management for papillary thyroid microcarcinoma. Thyroid 2021;31:183-192  https://doi.org/10.1089/thy.2020.0330
  35. Tuttle RM, Fagin JA, Minkowitz G, Wong RJ, Roman B, Patel S, et al. Natural history and tumor volume kinetics of papillary thyroid cancers during active surveillance. JAMA Otolaryngol Head Neck Surg 2017;143:1015-1020  https://doi.org/10.1001/jamaoto.2017.1442
  36. Oh HS, Ha J, Kim HI, Kim TH, Kim WG, Lim DJ, et al. Active surveillance of low-risk papillary thyroid microcarcinoma: a multi-center cohort study in Korea. Thyroid 2018;28:1587-1594  https://doi.org/10.1089/thy.2018.0263
  37. Kwon H, Oh HS, Kim M, Park S, Jeon MJ, Kim WG, et al. Active surveillance for patients with papillary thyroid microcarcinoma: a single center's experience in Korea. J Clin Endocrinol Metab 2017;102:1917-1925  https://doi.org/10.1210/jc.2016-4026
  38. Chung SR, Choi YJ, Lee SS, Kim SO, Lee SA, Jeon MJ, et al. Interobserver reproducibility in sonographic measurement of diameter and volume of papillary thyroid microcarcinoma. Thyroid 2021;31:452-458  https://doi.org/10.1089/thy.2020.0317
  39. Ahuja A, Chick W, King W, Metreweli C. Clinical significance of the comet-tail artifact in thyroid ultrasound. J Clin Ultrasound 1996;24:129-133  https://doi.org/10.1002/(SICI)1097-0096(199603)24:3<129::AID-JCU4>3.0.CO;2-J
  40. Sohn YM, Na DG, Paik W, Gwon HY, Noh BJ. Malignancy risk of thyroid nodules with nonshadowing echogenic foci. Ultrasonography 2021;40:115-125  https://doi.org/10.14366/usg.20012
  41. Kim JH, Baek JH, Lim HK, Ahn HS, Baek SM, Choi YJ, et al. 2017 thyroid radiofrequency ablation guideline: Korean Society of Thyroid Radiology. Korean J Radiol 2018;19:632-655  https://doi.org/10.3348/kjr.2018.19.4.632
  42. Hahn SY, Shin JH, Na DG, Ha EJ, Ahn HS, Lim HK, et al. Ethanol ablation of the thyroid nodules: 2018 consensus statement by the Korean Society of Thyroid Radiology. Korean J Radiol 2019;20:609-620  https://doi.org/10.3348/kjr.2018.0696
  43. Park JS, Son KR, Na DG, Kim E, Kim S. Performance of preoperative sonographic staging of papillary thyroid carcinoma based on the sixth edition of the AJCC/UICC TNM classification system. AJR Am J Roentgenol 2009;192:66-72  https://doi.org/10.2214/AJR.07.3731
  44. Yoo RE, Kim JH, Bae JM, Hwang I, Kang KM, Yun TJ, et al. Ultrasonographic indeterminate lymph nodes in preoperative thyroid cancer patients: malignancy risk and ultrasonographic findings predictive of malignancy. Korean J Radiol 2020;21:598-604  https://doi.org/10.3348/kjr.2019.0755
  45. Sohn YM, Kwak JY, Kim EK, Moon HJ, Kim SJ, Kim MJ. Diagnostic approach for evaluation of lymph node metastasis from thyroid cancer using ultrasound and fine-needle aspiration biopsy. AJR Am J Roentgenol 2010;194:38-43  https://doi.org/10.2214/AJR.09.3128
  46. Rosario PW, de Faria S, Bicalho L, Alves MF, Borges MA, Purisch S, et al. Ultrasonographic differentiation between metastatic and benign lymph nodes in patients with papillary thyroid carcinoma. J Ultrasound Med 2005;24:1385-1389  https://doi.org/10.7863/jum.2005.24.10.1385
  47. Leboulleux S, Girard E, Rose M, Travagli JP, Sabbah N, Caillou B, et al. Ultrasound criteria of malignancy for cervical lymph nodes in patients followed up for differentiated thyroid cancer. J Clin Endocrinol Metab 2007;92:3590-3594  https://doi.org/10.1210/jc.2007-0444
  48. Lee JY, Yoo RE, Rhim JH, Lee KH, Choi KS, Hwang I, et al. Validation of ultrasound risk stratification systems for cervical lymph node metastasis in patients with thyroid cancer. Cancers (Basel) 2022;14:2106 
  49. Singh Ospina N, Genere N, Hoang JK, Brito JP. ACR TI-RADS recommendations: a call to contextualize radiologists' recommendations for thyroid nodules with the clinical scenario. J Am Coll Radiol 2021;18:1342-1344 https://doi.org/10.1016/j.jacr.2021.04.019