EDITORIAL March 01, 2018 March 01, 2018

Improving care of patients with low-risk differentiated thyroid carcinoma

DOI: 10.20945/2359-3997000000034

In the last decade, imaging techniques had a great improvement in quality and became widely available all over the world for screening and diagnosis of the vast majority of malignancies. However, concerning thyroid nodule and cancer, we frequently face cases where micronodules were found incidentally by ultrasonography and other image modalities, often performed without clear indication. Some advocate this might be one of the main reasons for the rising incidence of thyroid nodules and microcarcinomas (). Most Thyroid Societies advocate that nodules less than 0.5-1.0 cm should not be biopsied due to the low risk of those potential tumors (). The proper utility of diagnostic tools, however, can be used to tailor the management of these nodules leading to a more accurate diagnosis and, therefore, a more adequate therapeutic approach ().

In this issue of Archives of Endocrinology and Metabolism (AE&M), Macedo and cols. () described 195 thyroid nodules detected by ultrasound using two scoring systems: modified TI-RADS and ATA risk stratification, both scores based on ultrasonographic features. The results were compared to cytopathological analysis. Histopathological results, considered the golden standard for diagnosis of thyroid cancer, were available in 45 cases after surgery. They concluded that both TI-RADS and the ATA ultrasound guidelines have high sensitivity and NPV for the diagnosis of thyroid carcinoma, meaning they can accurately predict the probability of benignity. They also relate that both systems are easily applicable in a routine basis and can be used to tailor fine needle aspiration cytology (FNAC), avoiding unnecessary procedures (). These results are in agreement with other studies that evaluated the ultrasound findings in order to define criteria for indication of FNAC in a suspicious nodules with accurate results.

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