2013 European thyroid association guidelines for cervical ultrasound scan and ultrasound-guided techniques in the postoperative management of patients with thyroid cancer.
Cervical ultrasound scanning (US) is considered a key examination, by all major thyroid and endocrine specialist societies for the postoperative follow-up of thyroid cancer patients to assess the risk of recurrence. Neck US imaging is readily available, non-invasive, relatively easy to perform, cost-effective, and can guide diagnostic and therapeutic procedures with low complication rates. Its main shortcoming is its operator-dependency. Because of the pivotal role of US in the care of thyroid cancer patients, the European Thyroid Association convened a panel of international experts to review technical aspects, indications, results, and limitations of cervical US in the initial staging and follow-up of thyroid cancer patients. The main aim is to establish guidelines for both a cervical US scanning protocol and US-guided diagnostic and therapeutic procedures in patients with thyroid cancer. This report presents (1) standardization of the US scanning procedure, techniques of US-guided fine-needle aspiration, and reporting of findings; (2) definition of criteria for classification of malignancy risk based on cervical US imaging characteristics of neck masses and lymph nodes; (3) indications for US-guided fine-needle aspiration and for biological in situ assessments; (4) proposal of an algorithm for the follow-up of thyroid cancer patients based on risk stratification following histopathological and cervical US findings, and (5) discussion of the potential use of US-guided localization and ablation techniques for locoregional thyroid metastases.
Department of Nuclear Medicine, Pitié Salpêtrière Hospital, Cancer Institute, Pierre et Marie Curie University, Paris, France.
L
L
Leenhardt
Department of Endocrinology and Metabolism, University of Ankara School of Medicine, İbni Sina Hastanesi, Ankara, Turkey.
M F
MF
Erdogan
Department of Endocrinology and Metabolism, Odense University Hospital, Odense, Denmark.
L
L
Hegedus
Division of Endocrinology, Diabetes and Metabolism, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pa., USA.
S J
SJ
Mandel
Department of Endocrinology, University of Leipzig, Leipzig, Germany.
R
R
Paschke
Endocrine Unit 1, Department of Internal Medicine, Ospedale Cisanello, University of Pisa, Pisa, Italy.
T
T
Rago
Department of Nuclear Medicine, Pitié Salpêtrière Hospital, Cancer Institute, Pierre et Marie Curie University, Paris, France.
G
G
Russ
Ethanol injection; Fine-needle aspiration biopsy; Laser therapy; Lymph nodes; Neck ultrasonography; Recurrence risk stratification; Thyroglobulin