SFE-AFCE-SFMN 2022 consensus on the management of thyroid nodules: Synthesis and algorithms

A Narrative Review of the 2023 Korean Thyroid Association Management Guideline for Patients with Thyroid Nodules

“…For these individuals, screening should begin after the successful treatment of the primary cancer. It is recommended that they undergo annual or biannual physical examinations, accompanied by thyroid US every 5 years [ 7 , 17 , 18 ].…”

“…The initial evaluation of thyroid nodules includes thyroid function test (TFT) (thyroid stimulating hormone [TSH] and free thyroxine). Routine measurements of serum thyroglobulin or calcitonin are not recommended because of their low specificity [ 7 , 19 ]. However, calcitonin testing is recommended in certain situations—specifically, for thyroid nodules suspicious for MTC, patients with a family history of MTC, and before surgery [ 7 ].…”

“…Routine measurements of serum thyroglobulin or calcitonin are not recommended because of their low specificity [ 7 , 19 ]. However, calcitonin testing is recommended in certain situations—specifically, for thyroid nodules suspicious for MTC, patients with a family history of MTC, and before surgery [ 7 ]. The algorithm for the diagnostic evaluation of thyroid nodules is presented in Fig.…”

“…For biopsy-proven benign nodules, those identified as high suspicion on US should be followed with US surveillance within 12 months, and repeated FNA should be performed if they do not shrink. In the 2022 French consensus, US-suspicious thyroid nodules (European Thyroid Imaging Reporting and Data System [EU-TIRADS] 5) with a benign FNA result (Bethesda II) should be monitored every 1–2 years for 5 years after detection, and then monitoring should be discontinued if the nodules are stable [ 7 ]. The ETA recommends repeating FNA for US-suspicious thyroid nodules with benign FNA results if the nodule size is >10 mm [ 19 ].…”

“…Regarding low to intermediate suspicion nodules on US, the 2023 KTA guideline recommend surveillance after 12 to 24 months and repeated FNA if significant nodule growth is observed [ 5 ]. The SFE recommends conducting surveillance after 1 to 2 years and repeating FNA only if the nodule characteristics warrant it [ 7 ]. The ETA recommends re-evaluating nodules (>20 mm for EU-TIRADS 3 or >15 mm for EU-TIRADS 4) in 3 to 5 years [ 19 ].…”