title: Ultrasound thyroid nodule measurements: the "gold standard" and its limitations in clinical decision making.
abstract: OBJECTIVE
  To highlight the limitations associated with use of ultrasonography for the evaluation of thyroid nodule or gland volume for clinical decision making.
  
  
  METHODS
  We review the equipment (scanners and probes) used for ultrasonography and the appropriate measurements for assessment of thyroid nodules. The limitations of ultrasound thyroid measurements are summarized, particularly in reference to repeated measurements over time.
  
  
  RESULTS
  Thyroid ultrasonography is the recognized "gold standard" for an accurate and reliable assessment of gland volume and thyroid nodules. Many endocrinologists refer patients for surgical treatment because of detection of growth of thyroid nodules. In daily practice, they often make this decision by comparing ultrasound thyroid measurements determined over time. Although reliable, evaluation of thyroid nodule volume by ultrasonography has technologic, biologic, and examination technique limitations. These are particularly important in routine clinical practice, where ultrasound measurements are performed in less standardized settings than in experimental trials.
  
  
  CONCLUSIONS
  In daily medical office applications, ultrasound measurements of thyroid nodules should be used with caution in decision making.
authors.affiliation: Unità Operativa di Endocrinologia, Arcispedale S. Maria Nuova, Viale Umberto I 50, 42100 Reggio Emilia, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Gallo
authors.forename: Marialaura
authors.initials: M
authors.lastname: Pesenti
authors.forename: Roberto
authors.initials: R
authors.lastname: Valcavi
mesh_terms: D000328:Adult; D006801:Humans; D012016:Reference Values; D012680:Sensitivity and Specificity; D013961:Thyroid Gland / Q000000981:diagnostic imaging; D016606:Thyroid Nodule / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000601:surgery; D013974:Thyroxine / Q000627:therapeutic use; D014463:Ultrasonography / Q000592:standards / Q000706:statistics & numerical data
chemical_list: D013974:Thyroxine