Endocrinol Metab.  2024 Feb;39(1):61-72. 10.3803/EnM.2024.1938.

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

• Lee EK
• Park YJ
• Jung CK
• Na DG

• KMID: 2552796
• DOI: http://doi.org/10.3803/EnM.2024.1938

Abstract

The 2023 Korean Thyroid Association (KTA) Management Guideline for Patients with Thyroid Nodules constitute an update of the 2016 KTA guideline for thyroid nodules and cancers that focuses specifically on nodules. The 2023 guideline aim to offer updated guidance based on new evidence that reflects the changes in clinical practice since the 2016 KTA guideline. To update the 2023 guideline, a comprehensive literature search was conducted from January 2022 to May 2022. The literature search included studies, reviews, and other evidence involving human subjects that were published in English in MEDLINE (PubMed), Embase, and other relevant databases. Additional significant clinical trials and research studies published up to April 2023 were also reviewed. The limitations of the current evidence are discussed, and suggestions for areas in need of further research are identified. The purpose of this review is to provide a summary of the 2023 KTA guideline for the management of thyroid nodules released in May 2023 and to give a balanced insight with comparison of recent guidelines from other societies.

Keyword

Thyroid nodule; Guideline; Diagnosis; Treatment

Figure

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  Fig. 1. Initial evaluation for the diagnosis of thyroid nodules. TSH, thyroid stimulating hormone; T4, thyroxine; US, ultrasonography; K-TIRADS, Korean Thyroid Imaging Reporting and Data System; FNA, fine-needle aspiration; AUS, atypia of undetermined significance.

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  Fig. 2. Diagnostic work-up algorithm based on ultrasonography (US) features (Korean Thyroid Imaging Reporting and Data System [K-TIRADS]). A significant growth is defined as a diameter increase of 20% or more that is greater than 2 mm in at least two dimensions, or a volume increase of 50% or more. ROM, risk of malignancy; FNA, fine-needle aspiration.

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  Fig. 3. Follow-up algorithm based on pathological and radiologic assessment. Reproduced from Ha et al. [1]. ROM, risk of malignancy; AUS, atypia of undetermined significance; FN, follicular neoplasm; K-TIRADS, Korean Thyroid Imaging Reporting and Data System; FNA, fine-needle aspiration; CNB, core needle biopsy; US, ultrasonography. aActive surveillance instead of immediate surgery can be considered for adults with probable or proven low-risk papillary microcarcinoma.

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