L. Leenhardt
L. Leenhardt
Department of Nuclear Medicine, Pitié Salpêtrière Hospital, Cancer Institute, Pierre et Marie Curie University, Paris, France
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M.F. Erdogan
M.F. Erdogan
Department of Endocrinology and Metabolism, University of Ankara School of Medicine, İbni Sina Hastanesi, Ankara, Turkey
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L. Hegedus
L. Hegedus
Department of Endocrinology and Metabolism, Odense University Hospital, Odense, Denmark
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S.J. Mandel
S.J. Mandel
Division of Endocrinology, Diabetes and Metabolism, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pa., USA
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R. Paschke
R. Paschke
Department of Endocrinology, University of Leipzig, Leipzig, Germany
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T. Rago
T. Rago
Endocrine Unit 1, Department of Internal Medicine, Ospedale Cisanello, University of Pisa, Pisa, Italy
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G. Russ
G. Russ
Department of Nuclear Medicine, Pitié Salpêtrière Hospital, Cancer Institute, Pierre et Marie Curie University, Paris, France
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published guidelines, in the first 1-2 years after initial surgery and radioiodine treatment, risk restratification relies primarily on thyroglobulin (Tg) measurement and neck ultrasound (US). The usefulness of neck US for the assessment of therapeutic
J L Reverter
J L Reverter
Endocrinology and Nutrition Service, Germans Trias i Pujol Hospital and Research Institute, Badalona, Spain
Department of Medicine, Autonomous University of Barcelona, Barcelona, Spain
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Department of Medicine, Autonomous University of Barcelona, Barcelona, Spain
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L Ferrer-Estopiñan
L Ferrer-Estopiñan
Endocrinology and Nutrition Service, Germans Trias i Pujol Hospital and Research Institute, Badalona, Spain
Department of Medicine, Autonomous University of Barcelona, Barcelona, Spain
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Department of Medicine, Autonomous University of Barcelona, Barcelona, Spain
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F Vázquez
F Vázquez
Endocrinology and Nutrition Service, Germans Trias i Pujol Hospital and Research Institute, Badalona, Spain
Department of Medicine, Autonomous University of Barcelona, Barcelona, Spain
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Department of Medicine, Autonomous University of Barcelona, Barcelona, Spain
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S Ballesta
S Ballesta
Endocrinology and Nutrition Service, Germans Trias i Pujol Hospital and Research Institute, Badalona, Spain
Department of Medicine, Autonomous University of Barcelona, Barcelona, Spain
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Department of Medicine, Autonomous University of Barcelona, Barcelona, Spain
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S Batule
S Batule
Endocrinology and Nutrition Service, Germans Trias i Pujol Hospital and Research Institute, Badalona, Spain
Department of Medicine, Autonomous University of Barcelona, Barcelona, Spain
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Department of Medicine, Autonomous University of Barcelona, Barcelona, Spain
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A Perez-Montes de Oca
A Perez-Montes de Oca
Endocrinology and Nutrition Service, Germans Trias i Pujol Hospital and Research Institute, Badalona, Spain
Department of Medicine, Autonomous University of Barcelona, Barcelona, Spain
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Department of Medicine, Autonomous University of Barcelona, Barcelona, Spain
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C Puig-Jové
C Puig-Jové
Endocrinology and Nutrition Service, Germans Trias i Pujol Hospital and Research Institute, Badalona, Spain
Department of Medicine, Autonomous University of Barcelona, Barcelona, Spain
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Department of Medicine, Autonomous University of Barcelona, Barcelona, Spain
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M Puig-Domingo
M Puig-Domingo
Endocrinology and Nutrition Service, Germans Trias i Pujol Hospital and Research Institute, Badalona, Spain
Department of Medicine, Autonomous University of Barcelona, Barcelona, Spain
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Department of Medicine, Autonomous University of Barcelona, Barcelona, Spain
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nodules has enhanced the need for endocrinologists to be able to define the risk of malignancy as accurately as possible ( 2 ). Ultrasound (US) is the first-line method to identify malignant thyroid nodules with the advantages of accessibility, cost
Till Ittermann
Till Ittermann
Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
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Adrian Richter
Adrian Richter
Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
German Rheumatism Research Center, Berlin, Germany
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German Rheumatism Research Center, Berlin, Germany
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Martin Junge
Martin Junge
Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
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Matthias Nauck
Matthias Nauck
Institute for Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
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Astrid Petersmann
Astrid Petersmann
Institute for Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
Institute for Clinical Chemistry, Interdisciplinary University Laboratory, University Medicine Göttingen, Göttingen, Germany
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Institute for Clinical Chemistry, Interdisciplinary University Laboratory, University Medicine Göttingen, Göttingen, Germany
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Clemens Jürgens
Clemens Jürgens
Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
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Harald Below
Harald Below
Institute of Hygiene and Environmental Medicine, University Medicine Greifswald, Greifswald, Germany
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Carsten Oliver Schmidt
Carsten Oliver Schmidt
Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
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Henry Völzke
Henry Völzke
Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
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reader variations are particularly essential to evaluate ultrasound (US) techniques such as assessments of thyroid volume and thyroid nodules [ 7 ]. Likewise, US devices as well as laboratory measurement techniques may be prone to variations [ 8 ]. It
Helmi Khadra
Helmi Khadra
Division of Endocrine and Oncologic Surgery, Department of Surgery, Tulane University School of Medicine, New Orleans, Louisiana, USA
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Ahmed Deniwar
Ahmed Deniwar
Division of Endocrine and Oncologic Surgery, Department of Surgery, Tulane University School of Medicine, New Orleans, Louisiana, USA
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Khuzema Mohsin
Khuzema Mohsin
Division of Endocrine and Oncologic Surgery, Department of Surgery, Tulane University School of Medicine, New Orleans, Louisiana, USA
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Dominique Monlezun
Dominique Monlezun
Tulane University School of Medicine, New Orleans, Louisiana, USA
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Emad Kandil
Emad Kandil
Division of Endocrine and Oncologic Surgery, Department of Surgery, Tulane University School of Medicine, New Orleans, Louisiana, USA
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nodules include an initial comprehensive history and physical and a thorough initial clinical evaluation, which includes a cervical ultrasound (US). As the management of malignant thyroid nodules is mostly surgical, it should be differentiated from
Gilles Russ
Gilles Russ
Thyroid and Endocrine Tumors, Institute of Endocrinology, Pitié Salpêtrière Hospital, Pierre and Marie Curie University, Paris, France
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Steen J. Bonnema
Steen J. Bonnema
Department of Endocrinology, Odense University Hospital, Odense, Denmark
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Murat Faik Erdogan
Murat Faik Erdogan
Department of Endocrinology and Metabolism, University of Ankara School of Medicine, İbni Sina Hastanesi, Ankara, Turkey
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Cosimo Durante
Cosimo Durante
Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, Italy
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Rose Ngu
Rose Ngu
Head Neck and Thyroid Imaging, Department of Radiology, Guy’s and St Thomas’ Hospitals NHS Foundation Trust, London, United Kingdom
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Laurence Leenhardt
Laurence Leenhardt
Thyroid and Endocrine Tumors, Institute of Endocrinology, Pitié Salpêtrière Hospital, Pierre and Marie Curie University, Paris, France
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clinical parameters, indications for FNA should be based on ultrasonographic malignancy risk stratification alongside clinical risk factors. Accuracy of Thyroid Ultrasound Features Certain features of thyroid nodules on ultrasound (US) are
Irini S. Hadjisavva
Irini S. Hadjisavva
Economides Nicosia Endocrinology Center, Nicosia, Cyprus
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Roberto Dina
Roberto Dina
Department of Cellular Pathology, Hammersmith Hospital, Imperial College Healthcare Trust, London, UK
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Michael A. Talias
Michael A. Talias
Healthcare Management Postgraduate Program, Open University of Cyprus, Nicosia, Cyprus
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Panayiotis A. Economides
Panayiotis A. Economides
Economides Nicosia Endocrinology Center, Nicosia, Cyprus
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malignant [ 3 , 5 , 6 , 7 ]. It is a simple, safe and most accurate method for selecting the patients who will need surgical resection or follow-up. Ultrasound-guided FNA (USgFNA) has improved diagnostic accuracy compared to FNA by palpation [ 8 , 9
Sze May Ng
Sze May Ng
Department of Women’s and Children’s Health, Institute of Translational Medicine, University of Liverpool, Liverpool, United Kingdom
Department of Paediatrics, Southport and Ormskirk NHS Trust, Ormskirk, United Kingdom
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Department of Paediatrics, Southport and Ormskirk NHS Trust, Ormskirk, United Kingdom
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Mark A. Turner
Mark A. Turner
Department of Women’s and Children’s Health, Institute of Translational Medicine, University of Liverpool, Liverpool, United Kingdom
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Shivaram Avula
Shivaram Avula
Department of Radiology, Alder Hey Foundation Trust Hospital, Liverpool, United Kingdom
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development and thyroid function [ 6 ]. Thyroid ultrasonography and radionuclide scanning are the imaging modalities of choice in the assessment of thyroid gland in infants and children [ 7 ]. Thyroid ultrasound is non-invasive and is superior to radionuclide
Tamas Solymosi
Tamas Solymosi
Endocrinology and Metabolism Clinic, Bugat Hospital, Gyöngyös, Hungary
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Laszlo Hegedüs
Laszlo Hegedüs
Department of Endocrinology and Metabolism, Odense University Hospital, Odense, Denmark
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Steen Joop Bonnema
Steen Joop Bonnema
Department of Endocrinology and Metabolism, Odense University Hospital, Odense, Denmark
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Andrea Frasoldati
Andrea Frasoldati
Endocrinology Unit of Arcispedale S. Maria Nuova, Reggio Emilia, Italy
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Laszlo Jambor
Laszlo Jambor
Department of Radiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
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Gabor Laszlo Kovacs
Gabor Laszlo Kovacs
1st Department of Medicine, Flohr Ferenc Hospital, Kerepestarcsa, Hungary
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Enrico Papini
Enrico Papini
Regina Apostolorum Hospital in Albano, Rome, Italy
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Karoly Rucz
Karoly Rucz
1st Department of Medicine, University of Pecs, Pecs, Hungary
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Gilles Russ
Gilles Russ
Unité Thyroïde et Tumeurs Endocrines – Pr Leenhardt Hôpital La Pitie Salpetriere, Sorbonne Université, Paris, France
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Zsolt Karanyi
Zsolt Karanyi
Division of Endocrinology, Department of Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
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Endre V. Nagy
Endre V. Nagy
Division of Endocrinology, Department of Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
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Introduction For more than three decades, the cornerstones in the clinical management of patients with thyroid nodules have been ultrasound (US) and fine-needle aspiration (FNA) cytology [ 1 - 5 ]. Robust evidence demonstrates that the risk of
Liyuan Liu
Liyuan Liu
Department of Endocrinology, Peking University First Hospital, Beijing, People’s Republic of China
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Yang Yu
Yang Yu
Department of Endocrinology, Peking University First Hospital, Beijing, People’s Republic of China
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Lei Chen
Lei Chen
Department of Ultrasound, Peking University First Hospital, Beijing, People’s Republic of China
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Yang Zhang
Yang Zhang
Department of Endocrinology, Peking University First Hospital, Beijing, People’s Republic of China
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Guizhi Lu
Guizhi Lu
Department of Endocrinology, Peking University First Hospital, Beijing, People’s Republic of China
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Ying Gao
Ying Gao
Department of Endocrinology, Peking University First Hospital, Beijing, People’s Republic of China
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Junqing Zhang
Junqing Zhang
Department of Endocrinology, Peking University First Hospital, Beijing, People’s Republic of China
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, heterogeneous, and normal echogenicity ( 3 , 15 ). Hypoechogenicity was defined as an ultrasound signal significantly lower than normal thyroid tissue. Heterogeneous echogenicity is defined as the interweaving of low signal and normal tissue signal ( 3
Cosimo Durante
Cosimo Durante
Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
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Laszlo Hegedüs
Laszlo Hegedüs
Department of Endocrinology, Odense University Hospital, Odense, Denmark
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Agnieszka Czarniecka
Agnieszka Czarniecka
M. Sklodowska-Curie National Research, Institute of Oncology Gliwice Branch, Gliwice, Poland
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Ralf Paschke
Ralf Paschke
Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
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Gilles Russ
Gilles Russ
Thyroid and Endocrine Tumors Department, Pitié-Salpêtrière Hospital, Sorbonne University GRC N°16, Paris, France
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Fernando Schmitt
Fernando Schmitt
Faculty of Medicine of University of Porto, CINTESIS@RISE and Institute of Molecular Pathology and Immunology, University of Porto (Ipatimup), Porto, Portugal
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Paula Soares
Paula Soares
Institute of Investigation and Innovation in Health (I3S), Faculty of Medicine of the University of Porto, Porto, Portugal
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Tamas Solymosi
Tamas Solymosi
Endocrinology and Metabolism Clinic, Bugat Hospital, Gyöngyös, Hungary
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Enrico Papini
Enrico Papini
Department of Endocrine and Metabolic Diseases, Regina Apostolorum Hospital, Albano, Rome, Italy
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patient into consideration. Based on the aforementioned, ultrasound (US) screening of asymptomatic adults is discouraged. Thus, the present guidelines aim at providing a clinical practice guide for the initial workup and the subsequent management of adult
