Korean J Radiol.  2021 Dec;22(12):2094-2123. 10.3348/kjr.2021.0713.

2021 Korean Thyroid Imaging Reporting and Data System and Imaging-Based Management of Thyroid Nodules: Korean Society of Thyroid Radiology Consensus Statement and Recommendations

Affiliations
  • 1Department of Radiology, Ajou University School of Medicine, Suwon, Korea
  • 2Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
  • 3Department of Radiology, GangNeung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Korea
  • 4Department of Radiology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea
  • 5Department of Radiology, Ewha Womans University School of Medicine, Seoul, Korea
  • 6Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
  • 7Department of Radiology, Hanyang University College of Medicine, Hanyang University Hospital, Seoul, Korea
  • 8Department of Radiology, Haeundae Sharing and Happiness Hospital, Busan, Korea
  • 9Department of Radiology, Kangwon National University Hospital, Chuncheon, Korea
  • 10Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
  • 11Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
  • 12Department of Radiology, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
  • 13Department of Radiology, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Hwasun, Korea
  • 14Department of Radiology, New Korea Hospital, Gimpo, Korea
  • 15Department of Radiology, Research Institute and Hospital, National Cancer Center, Goyang, Korea
  • 16Department of Radiology, Jeju National University, Jeju, Korea
  • 17Department of Radiology, Ansan Hospital, Korea University College of Medicine, Ansan, Korea
  • 18Department of Radiology, Soonchunhyang University Seoul Hospital, Seoul, Korea
  • 19Department of Radiology, Withsim Clinic, Seongnam, Korea
  • 20Department of Radiology and Thyroid Center, Daerim St. Mary's Hospital, Seoul, Korea
  • 21Department of Radiology, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, Korea
  • 22Division for Healthcare Technology Assessment Research, National Evidence-based Healthcare Collaborating Agency, Seoul, Korea

Abstract

Incidental thyroid nodules are commonly detected on ultrasonography (US). This has contributed to the rapidly rising incidence of low-risk papillary thyroid carcinoma over the last 20 years. The appropriate diagnosis and management of these patients is based on the risk factors related to the patients as well as the thyroid nodules. The Korean Society of Thyroid Radiology (KSThR) published consensus recommendations for US-based management of thyroid nodules in 2011 and revised them in 2016. These guidelines have been used as the standard guidelines in Korea. However, recent advances in the diagnosis and management of thyroid nodules have necessitated the revision of the original recommendations. The task force of the KSThR has revised the Korean Thyroid Imaging Reporting and Data System and recommendations for US lexicon, biopsy criteria, US criteria of extrathyroidal extension, optimal thyroid computed tomography protocol, and US follow-up of thyroid nodules before and after biopsy. The biopsy criteria were revised to reduce unnecessary biopsies for benign nodules while maintaining an appropriate sensitivity for the detection of malignant tumors in small (1–2 cm) thyroid nodules. The goal of these recommendations is to provide the optimal scientific evidence and expert opinion consensus regarding US-based diagnosis and management of thyroid nodules.

Keyword

Thyroid nodule; Thyroid neoplasm; Lymph nodes; Ultrasonography; Computed tomography; Fine needle aspiration
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