1 The recommendations are offered as general guidance and do not apply to all patients, such as those with clinical risk factors for thyroid cancer.
2 Suspicious CT/MRI features include: abnormal lymph nodes and/or invasion of local tissues by the thyroid nodule. Abnormal lymph node features include: calcifications, cystic components, and/or increased enhancement. Nodal enlargement is less specific for thyroid cancer metastases, but further evaluation could be considered if an ITN has ipsilateral nodes >1.5 cm in short axis for jugulodigastric lymph nodes, and >1 cm for other lymph nodes.
3 Limited life expectancy and comorbidities that increase the risk of treatment or are more likely to cause morbidity and mortality than the thyroid cancer itself, given the nodule size; see text for details. Patients with comorbidities or limited life expectancy should not have further evaluation of the ITN, unless it is warranted clinically, or specifically requested by the patient or referring physician.
4 Further management of the ITN after thyroid ultrasound, including fine-needle aspiration, should be based on ultrasound findings.
see full article for management of those nodules detected on a Nuclear Medicine study or non-thyroid Ultrasound