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Thyroid ultrasound and its ancillary techniques

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Abstract

Ultrasound (US) of the thyroid has been used as a diagnostic tool since the late 1960s. US is the most important imaging tool for diagnosing thyroid disease. In the majority of cases a correct diagnosis can already be made in synopsis of the sonographic together with clinical findings and basal thyroid hormone parameters. However, the characterization of thyroid nodules by US remains challenging. The introduction of Thyroid Imaging Reporting and Data Systems (TIRADSs) has improved diagnostic accuracy of thyroid cancer significantly. Newer techniques such as elastography, superb microvascular imaging (SMI), contrast enhanced ultrasound (CEUS) and multiparametric ultrasound (MPUS) expand diagnostic options and tools further. In addition, the use of artificial intelligence (AI) is a promising tool to improve and simplify diagnostics of thyroid nodules and there is evidence that AI can exceed the performance of humans. Combining different US techniques with the introduction of new software, the use of AI, FNB as well as molecular markers might pave the way for a completely new area of diagnostic accuracy in thyroid disease. Finally, interventional ultrasound using US-guided thermal ablation (TA) procedures are increasingly proposed as therapy options for benign as well as malignant thyroid diseases.

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Data availability

The data that support the findings of this review are openly available at http://doi.org.

Abbreviations

AI:

Artificial intelligence

ARFI:

Acoustic radiation force imaging

B-mode:

Brightness mode

CAD:

Computer-aided diagnosis

CEUS:

Contrast enhanced ultrasound

CFD:

Color flow Doppler

DL:

Deep learning

EA:

Ethanol ablation

ETA:

European Thyroid Association

FNB:

Fine needle biopsy

FTC:

Follicular thyroid carcinoma

ML:

Machine learning

MPUS:

Multiparametric ultrasound

MTC:

Medullary thyroid carcinoma

NPV:

Negative predictive value

PPV:

Positive predictive value

PRF:

Pulse repetition frequency

PTC:

Papillary thyroid carcinoma

PTMC:

Papillary thyroid microcarcinoma

RFA:

Radiofrequency ablation

SE:

Strain elastography

SMI:

Superb microvascular imaging

SWE:

Shear-wave elastography

TA:

Thermal ablation

THI:

Tissue harmonic imaging

TIC:

Time-Intensity-Curve

TIRADS:

Thyroid Imaging Reporting and Data Systems

US:

Ultrasound

USE:

Ultrasound elastography

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  1. Department of Medicine I, Goethe University Hospital, Theodor-Stern-Kai 7, Frankfurt am Main, 60590, Germany

    Joerg Bojunga

  2. Servizio di Endocrinologia e Diabetologia, Ospedale Regionale di Lugano, Ente Ospedaliero Cantonale (EOC), Lugano, Switzerland

    Pierpaolo Trimboli

  3. Facoltà di Scienze Biomediche, Università della Svizzera Italiana (USI), Lugano, Switzerland

    Pierpaolo Trimboli

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Bojunga, J., Trimboli, P. Thyroid ultrasound and its ancillary techniques. Rev Endocr Metab Disord 25, 161–173 (2024). https://doi.org/10.1007/s11154-023-09841-1

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