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Ultraschall Med
DOI: 10.1055/a-2761-1329
Guidelines & Recommendations

EFSUMB Guidelines on Multiparametric Ultrasound Thyroid Nodule Evaluation: PART II

n/a

Autoren

  • Vito Cantisani

    1   Department of Radiology, "Sapienza" University of Rome, ROME, Italy

  • Maija Radzina 

    2   Radiology Research laboratory, Riga Stradins University, Riga, Latvia (Ringgold ID: RIN87255)
    3   Diagnostic Radiology Institute, Paul Stradins Clinical University Hospital, Riga, Latvia (Ringgold ID: RIN87148)

  • Christoph F. Dietrich 

    4   Department General Internal Medicine (DAIM), Hospitals Hirslanden Bern Beau Site, Salem and Permanence, bern, Switzerland

  • Christian Jenssen 

    5   Department of Internal Medicine, Krankenhaus Märkisch Oderland Strausberg/Wriezen, Strausberg, Germany
    6   Brandenburg Institute for Clinical Ultrasound (BICUS), Brandenburg Institute for Clinical Ultrasound at Medical University Brandenburg, Neuruppin, Germany

  • Helmut Prosch 

    7   Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria (Ringgold ID: RIN27271)

  • Liat Appelbaum

    8   Radiology, Hadassah, Jerusalem, Israel

  • Richard G Barr 

    9   Radiology, Northeastern Ohio Medical University, youngstown, United States (Ringgold ID: RIN6969)

  • Kunwar S S Bhatia

    10   Department of Imaging and Interventional Radiology, Imperial College Healthcare NHS Trust, London, United Kingdom of Great Britain and Northern Ireland (Ringgold ID: RIN8946)

  • Manjiri Dighe

    11   Radiology, University of Washington Department of Biology, Seattle, United States (Ringgold ID: RIN124581)

  • Cosimo Durante

    12   Dept. of Translational and Precision Medicine, "Sapienza" University of Rome, ROME, Italy

  • Daniele Fresilli 

    13   Department of Radiology, "Sapienza" University of Rome, Cassino, Italy

  • Giorgio Grani 

    14   Dept. of Translational and Precision Medicine, "Sapienza" University of Rome, Rome, Italy

  • Chris Harvey

    15   Dept of Imaging, Hammersmith Hospital, Imperial College Healthcare NHS Trust, London, United Kingdom of Great Britain and Northern Ireland (Ringgold ID: RIN8946)

  • Pintong HUANG 

    16   Department of Ultrasonography, The 2nd Affiliated Hospital Zhejiang University College of Medicine, Hangzhou, China

  • Gordana Ivanac

    17   Dept.of Radiology, US Center, Univ. Hospital Dubrava, University of Zagreb School of Medicine, Zagreb, Croatia

  • Adrian Lim 

    18   Imaging, Imperial College, London, United Kingdom of Great Britain and Northern Ireland

  • S Sureyya Ozbek

    19   Radiology, Ege University School of Medicine, Izmir, Turkey

  • mustafa Secil

    20   RADIOLOGY, DOKUZ EYLUL UNIVERSITY FACULTY OF MEDICINE, IZMIR, Turkey

  • Tobias Todsen

    21   Department of Otorhinolaryngology, Head and Neck Surgery & Audiology, Copenhagen University Hospital, Kobenhavn, Denmark (Ringgold ID: RIN53146)
    22   Copenhagen Academy for Medical Education and Simulation, Copenhagen Academy for Medical Education and Simulation, Copenhagen, Denmark (Ringgold ID: RIN615551)

  • Pierpaolo Trimboli

    23   Thyroid Unit, Clinic for Endocrinology and Diabetology, Repubblica e Cantone Ticino Ente Ospedaliero Cantonale, Bellinzona, Switzerland (Ringgold ID: RIN30696)
    24   Faculty of Biomedical Sciences, Università della Svizzera italiana, Lugano, Switzerland (Ringgold ID: RIN27216)
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Thyroid nodules are common incidental findings but only a small proportion of cases are malignant (4-6.5%) or symptomatic. Numerous follow-up examinations and invasive diagnostic procedures, such as fine-needle aspiration, fine-needle biopsies, and thyroidectomies, are performed, leading to potentially costly and time-consuming diagnostic procedures and overtreatment. Most experts and scientific societies (EFSUMB, WFUMB...) encourage the use of multiparametric ultrasound evaluation to improve the thyroid nodule characterization thanks also to the continuous technological developments with different ultrasound software (Microvascular flow imaging, Elastosonography...), contrast media (CEUS) and artificial intelligence (AI). Therefore, the recognition and proper use of new multiparametric ultrasound features of thyroid nodules are essential to minimize unnecessary interventions and guide appropriate treatments, also stimulating their use in routine clinical practice, which is the aim of our guideline. In addition, we analyze the use of MPUS in some emblematic thyroid scenarios such as cytologically indeterminate nodule, multinodular goiter and extrathyroidal extension of the malignant nodule and the usefulness of MPUS as a guide to thyroid biopsy/aspiration and in the staging of cervical lymph nodes. For each question, recommendations based on the level of evidence of the published literature and on the EFSUMB expert group's consensus are given.



Publikationsverlauf

Eingereicht: 17. Juni 2025

Angenommen nach Revision: 17. November 2025

Accepted Manuscript online:
02. Dezember 2025

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