title: Follow-up ultrasound may be enough for thyroid nodules from 5 mm to 1 cm in size.
abstract: We investigated whether follow-up ultrasound (US) is enough for thyroid nodules 5-10 mm, and whether 3 years of interval between the initial US and next US is appropriate. This retrospective study was approved by the Institutional Review Board, and the need to obtain informed consent was waived. The study included 447 thyroid nodules 5-10 mm from 378 patients who underwent initial thyroid US, and underwent 3 years or more of follow-up US. The presence and characteristics of malignancy detected on follow-up were reviewed. Maximal diameters of each nodule at the initial and last US were measured. Univariate and multivariate analysis were used to assess association with nodule growth 3 mm or larger. Seven malignancies (1.6 %, 7 of 447) were detected on a mean 70.6 ± 20.3 months (range 36-104 months). Only one had growth 3 mm or larger, and all malignancies did not have extensive extrathyroidal extension, lateral lymph nodes, or distant metastasis. 6.0 % (27 of 447) of nodules had growth 3 mm or larger. Nodules in older patients were less likely to grow, and benign-looking nodules were more likely to grow. Longer follow-up time 6 years or more was not associated with growth, and no cancers were detected during the long follow-up time. Immediate US-FNA for thyroid nodules 5-10 mm are discouraged, unless suspicious metastatic lymph nodes are present. Also, a follow-up US 3 years after the initial US may be enough for these nodules.
authors.affiliation: Department of Radiology, Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, 50 Yonse-ro, Seodaemun-gu, Seoul, 120-752, Korea.
authors.forename: Soo-Yeon
authors.initials: SY
authors.lastname: Kim
authors.affiliation: Biostatistics Collaboration Unit, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Hye Sun
authors.initials: HS
authors.lastname: Lee
authors.affiliation: Department of Radiology, Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, 50 Yonse-ro, Seodaemun-gu, Seoul, 120-752, Korea.
authors.forename: Eun-Kyung
authors.initials: EK
authors.lastname: Kim
authors.affiliation: Department of Radiology, Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, 50 Yonse-ro, Seodaemun-gu, Seoul, 120-752, Korea.
authors.forename: Hee Jung
authors.initials: HJ
authors.lastname: Moon
authors.affiliation: Department of Radiology, Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, 50 Yonse-ro, Seodaemun-gu, Seoul, 120-752, Korea.
authors.forename: Jung Hyun
authors.initials: JH
authors.lastname: Yoon
authors.affiliation: Biostatistics Collaboration Unit, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Jung Hwa
authors.initials: JH
authors.lastname: Hong
authors.affiliation: Department of Radiology, Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, 50 Yonse-ro, Seodaemun-gu, Seoul, 120-752, Korea. docjin@yuhs.ac.
authors.forename: Jin Young
authors.initials: JY
authors.lastname: Kwak
mesh_terms: D000328:Adult; D000368:Aged; D044963:Biopsy, Fine-Needle; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008198:Lymph Nodes / Q000000981:diagnostic imaging / Q000473:pathology*; D008207:Lymphatic Metastasis / Q000000981:diagnostic imaging / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013964:Thyroid Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D016606:Thyroid Nodule / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000601:surgery; D014463:Ultrasonography; D055815:Young Adult
keywords: Fine needle aspiration; Nodule growth; Thyroid nodules 5–10 mm; Ultrasound