J Korean Soc Radiol.
2024 Nov;85(6):1060-1082. 10.3348/jksr.2024.0132.
Standardized Ultrasound Evaluation for Active Surveillance of Low-Risk Thyroid Microcarcinoma in Adults: 2024 Korean Society of Thyroid Radiology Consensus Statement
- Lee JY
1 - Lee MK2
- Lim HK3
- Lee CY4
- Sung JY5
- Yoon JH6
- Hahn SY7
- Shin JH7
- Kim Jh1
- Jung SL8
- Chung SR9
- Baek JH9
- Na DG10
- Korean Society of Thyroid Radiology (KSThR) and Korean Society of Radiology
- Affiliations
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- 1Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
- 2Department of Radiology, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
- 3Department of Radiology, Soonchunhyang University Seoul Hospital, Seoul, Korea
- 4Department of Radiology, Research Institute and Hospital, National Cancer Center, Goyang, Korea
- 5Department of Radiology and Thyroid Center, Daerim St. Mary’s Hospital, Seoul, Korea
- 6Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
- 7Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
- 8Department of Radiology, St. Vincent’s Hospital, The Catholic University of Korea, Suwon, Korea
- 9Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
- 10Department of Radiology, Gangneung Asan Hospital, Ulsan University College of Medicine, Gangneung, Korea
- KMID: 2561721
- DOI: http://doi.org/10.3348/jksr.2024.0132
Abstract
- Active surveillance (AS) has been widely adopted as an alternative to immediate surgery owing to the indolent nature and favorable outcomes of papillary thyroid microcarcinoma (PTMC). AS is generally recommended for tumors measuring ≤1 cm without aggressive cytological subtypes, risk of gross extrathyroidal extension (ETE), lymph node metastasis (LNM), or distant metastasis. AS requires careful patient selection based on various patient and tumor characteristics, and ultrasound (US) findings. Moreover, during AS, regular US is performed to monitor any signs of tumor progression, including tumor growth, new US features of potential gross ETE, and LNM. Therefore, appropriate imaging-based assessment plays a crucial role in determining whether AS or surgery should be pursued. However, detailed recommendations concerning US evaluation are currently insufficient, necessitating the formulation of this guideline. The Korean Society of Thyroid Radiology has developed a consensus statement for low-risk PTMC, covering US assessment methods when considering AS as a management option and conducting follow-up imaging tests during AS. This guideline aims to provide optimal scientific evidence and expert opinion consensus regarding a standardized US-based assessment protocol for low-risk PTMC.
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