The DOI matches its Crossref record; 58 of the 58 references it cites were found in a registry or an index.
The Diagnosis and Management of Thyroid Nodules: A Review
Abstract
IMPORTANCE: Thyroid nodules are common, being detected in up to 65% of the general population. This is likely due to the increased use of diagnostic imaging for purposes unrelated to the thyroid. Most thyroid nodules are benign, clinically insignificant, and safely managed with a surveillance program. The main goal of initial and long-term follow-up is identification of the small subgroup of nodules that harbor a clinically significant cancer (≈10%), cause compressive symptoms (≈5%), or progress to functional disease (≈5%). OBSERVATIONS: Thyroid function testing and ultrasonographic characteristics guide the initial management of thyroid nodules. Certain ultrasound features, such as a cystic or spongiform appearance, suggest a benign process that does not require additional testing. Suspicious sonographic patterns including solid composition, hypoechogenicity, irregular margins, and microcalcifications should prompt cytological evaluation. Additional diagnostic procedures, such as molecular testing, are indicated only in selected cases, such as indeterminate cytology (≈20%-30% of all biopsies). The initial risk estimate, derived from ultrasound and, if performed, cytology report, should determine the need for treatment and the type, frequency, and length of subsequent follow-up. Management includes simple observation, local treatments, and surgery and should be based on the estimated risk of malignancy and the presence and severity of compressive symptoms. CONCLUSIONS AND RELEVANCE: Most thyroid nodules are benign. A diagnostic approach that uses ultrasound and, when indicated, fine-needle aspiration biopsy and molecular testing, facilitates a personalized, risk-based protocol that promotes high-quality care and minimizes cost and unnecessary testing.
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Haugen, B. R., Alexander, E. K., Bible, K. C., Doherty, G. M., Mandel, S. J., Nikiforov, Y. E., Pacini, F., Randolph, G. W., Sawka, A. M., Schlumberger, M., et al. (2016) · Thyroid® · doi:10.1089/thy.2015.0020 · Cited by 16,535
Self-citationACR Thyroid Imaging, Reporting and Data System (TI-RADS): White Paper of the ACR TI-RADS Committee
Tessler, F. N., Middleton, W. D., Grant, E. G., Hoang, J. K., Berland, L. L., Teefey, S. A., Cronan, J. J., Beland, M. D., Desser, T. S., Frates, M. C., et al. (2017) · Journal of the American College of Radiology · doi:10.1016/j.jacr.2017.01.046 · Cited by 2,530
Wells, S. A., Asa, S. L., Dralle, H., Elisei, R., Evans, D. B., Gagel, R. F., Lee, N., Machens, A., Moley, J. F., Pacini, F., et al. (2015) · Thyroid · doi:10.1089/thy.2014.0335 · Cited by 2,444
Management of a Solitary Thyroid Nodule
Desforges, J. F., & Mazzaferri, E. L. (1993) · New England Journal of Medicine · doi:10.1056/nejm199302253280807 · Cited by 1,412
Nikiforov, Y. E., Seethala, R. R., Tallini, G., Baloch, Z. W., Basolo, F., Thompson, L. D. R., Barletta, J. A., Wenig, B. M., Al Ghuzlan, A., Kakudo, K., et al. (2016) · JAMA Oncology · doi:10.1001/jamaoncol.2016.0386 · Cited by 1,404
Guidelines for the management of thyroid cancer
Perros, P., Boelaert, K., Colley, S., Evans, C., Evans, R. M., Gerrard BA, G., Gilbert, J., Harrison, B., Johnson, S. J., Giles, T. E., et al. (2014) · Clinical Endocrinology · doi:10.1111/cen.12515 · Cited by 1,372
Russ, G., Bonnema, S. J., Erdogan, M. F., Durante, C., Ngu, R., & Leenhardt, L. (2017) · European Thyroid Journal · doi:10.1159/000478927 · Cited by 1,284
Self-citationGharib, H., Papini, E., Garber, J. R., Duick, D. S., Harrell, R. M., Hegedus, L., Paschke, R., Valcavi, R., & Vitti, P. (2016) · Endocrine Practice · doi:10.4158/ep161208.gl · Cited by 1,272
Preoperative Diagnosis of Benign Thyroid Nodules with Indeterminate Cytology
Alexander, E. K., Kennedy, G. C., Baloch, Z. W., Cibas, E. S., Chudova, D., Diggans, J., Friedman, L., Kloos, R. T., LiVolsi, V. A., Mandel, S. J., et al. (2012) · New England Journal of Medicine · doi:10.1056/nejmoa1203208 · Cited by 1,163
Self-citationBenign and Malignant Thyroid Nodules: US Differentiation—Multicenter Retrospective Study
Moon, W.-J., Jung, S. L., Lee, J. H., Na, D. G., Baek, J.-H., Lee, Y. H., Kim, J., Kim, H. S., Byun, J. S., & Lee, D. H. (2008) · Radiology · doi:10.1148/radiol.2473070944 · Cited by 1,104
Cited by
Steward, D. L., Carty, S. E., Sippel, R. S., Yang, S. P., Sosa, J. A., Sipos, J. A., Figge, J. J., Mandel, S., Haugen, B. R., Burman, K. D., et al. (2019) · JAMA Oncology · doi:10.1001/jamaoncol.2018.4616 · Cited by 486
Self-citationLi, Y., Teng, D., Ba, J., Chen, B., Du, J., He, L., Lai, X., Teng, X., Shi, X., Li, Y., et al. (2020) · Thyroid · doi:10.1089/thy.2019.0067 · Cited by 359
Interconnection between circadian clocks and thyroid function
Ikegami, K., Refetoff, S., Van Cauter, E., & Yoshimura, T. (2019) · Nature Reviews Endocrinology · doi:10.1038/s41574-019-0237-z · Cited by 251
Wang, Z., Zhang, Z., Traverso, A., Dekker, A., Qian, L., & Sun, P. (2024) · Quantitative Imaging in Medicine and Surgery · doi:10.21037/qims-23-1180 · Cited by 46
Metadata
- Authors
- Durante, C., Grani, G., Lamartina, L., Filetti, S., Mandel, S. J., & Cooper, D. S.
- Venue
- JAMA
- Publisher
- American Medical Association (AMA)
- Published
- 2018-03-06
- Volume
- 319
- Issue
- 9
- Pages
- 914
- ISSN
- 0002-9955 (ISSN-L)
- 0098-7484
- OpenAlex
- W2789538733
- Cited by
- 803
- References
- 58
- FWCI
- 37.52
- Type
- journal article
- Language
- en
- Open access
- closed
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