ACR Appropriateness Criteria® thyroid carcinoma.
The ACR Head and Neck Cancer Appropriateness Criteria Committee reviewed relevant medical literature to provide guidance for those managing patients with thyroid carcinoma. The American College of Radiology Appropriateness Criteriaare evidence-based guidelines for specific clinical conditions that are reviewed every 2 years by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer reviewed journals and the application of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures by the panel. In those instances where evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment. Thyroid cancer is the most common endocrine malignancy in the United States, most often presenting as a localized palpable nodule. Surgery is the mainstay of treatment for WDTC, with most patients undergoing complete resection of their disease having good outcomes. Following surgery thyroxine supplementation should begin to suppress TSH, which unchecked can stimulate residual disease and/or metastatic progression, Adjuvant treatment with radioactive iodine (RAI) using iodine-131 ((131)I) is frequently used for diagnostic and therapeutic purposes. The use of EBRT for thyroid cancer has not been tested in well-designed, randomized, controlled trials and should, therefore, be considered on a case-by-case basis. Chemotherapy plays a minimal role in the management of WDTC. Novel biologic agents, such as systemic therapy options, are being actively investigated, and patients with metastatic thyroid cancer that is not iodine avid should be encouraged to enroll in clinical trials exploring novel systemic agents.
Duke University, Durham, NC, United States. Electronic address: joseph.salama@duke.edu.
Joseph K
JK
Salama
University of Chicago Hospital, Chicago, IL, United States.
Daniel W
DW
Golden
University of California San Francisco, San Francisco, CA, United States.
Sue S
SS
Yom
Montefiore Medical Center, Bronx, NY, United States.
Madhur Kumar
MK
Garg
Lexington Medical Center, West Columbia, SC, United States.
Joshua
J
Lawson
Indiana University School of Medicine, Indianapolis, IN, United States.
Mark W
MW
McDonald
Johns Hopkins University, Baltimore, MD, United States.
Harry
H
Quon
American College of Surgeons, Fox Chase Cancer Center, Philadelphia, PA, United States.
John A
JA
Ridge
American Society of Clinical Oncology, Emory University, Atlanta, GA, United States.
Nabil
N
Saba
American College of Surgeons, Montefiore Medical Center, Bronx, NY, United States.
Richard V
RV
Smith
American Society of Clinical Oncology, University of Michigan, Ann Arbor, Michigan, United States.
Francis
F
Worden
University of Florida, Gainesville, FL, United States.
Anamaria Reyna
AR
Yeung
Emory University School of Medicine, Atlanta, GA, United States.
Jonathan J
JJ
Beitler
D032921:Consensus; D006801:Humans; D013964:Thyroid Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000628:therapy
Anaplastic thyroid cancer; Appropriateness Criteria; Medullary thyroid cancer; Radiotherapy thyroid cancer; Thyroid cancer; Well differentiated thyroid cancer