Standardized Ultrasound Report for Thyroid Nodules: The Endocrinologist's Viewpoint.
BACKGROUND
Ultrasonography (US) plays a crucial role in the diagnostic management of thyroid nodules, but its widespread use in clinical practice might generate heterogeneity in ultrasound reports.


OBJECTIVE
The aims of the study were to propose (a) a standardized lexicon for description of thyroid nodules in order to reduce US reports of interobserver variability and (b) a US classification system of suspicion for thyroid nodules in order to promote a uniform management of thyroid nodules.


METHODS
RELEVANT PUBLISHED ARTICLES WERE IDENTIFIED BY SEARCHING MEDLINE AT PUBMED COMBINING THE FOLLOWING SEARCH TERMS: ultrasonography, thyroid, nodule, malignancy, carcinoma, and classification system. Results were supplemented with our data and experience.


RESULTS
A STANDARDIZED US REPORT SHOULD ALWAYS DOCUMENT POSITION, EXTRACAPSULAR RELATIONSHIPS, NUMBER, AND THE FOLLOWING CHARACTERISTICS OF EACH THYROID LESION: shape, internal content, echogenicity, echotexture, presence of calcifications, margins, vascularity, and size. Combining the previous US features, each thyroid nodule can be tentatively classified as: malignant, suspicious for malignancy, borderline, probably benign, and benign.


CONCLUSIONS
We propose a standardized US report and a tentative US classification system that may become helpful for endocrinologists dealing with thyroid nodules in their clinical practice. The proposed classification does not allow to bypass the required cytological confirmation, but may become useful in identifying the lesions with a lower risk of neoplasm.
Division of Endocrine and Metabolic Diseases, San Luca Hospital, Istituto Auxologico Italiano, Milan, Italy.
Massimiliano
M
Andrioli
Division of Endocrine and Metabolic Diseases, San Luca Hospital, Istituto Auxologico Italiano, Milan, Italy.
Chiara
C
Carzaniga
Division of Endocrine and Metabolic Diseases, San Luca Hospital, Istituto Auxologico Italiano, Milan, Italy ; Dipartimento di Scienze Cliniche e di Comunità, Università degli Studi di Milano, Milan, Italy.
Luca
L
Persani
Carcinoma; Elastography; Malignancy; Nodule; Thyroid; Tumor; Ultrasonography; Ultrasound