Introduction: Thyroid Ultrasound (US) is the recommended first line investigation of suspected thyroid nodules. Specific radiological features, such as micro-calcification, low echogenicity, solid consistency, heterogeneity and ill-defined margins, raise the possibility of underlying malignancy. These findings together with fine needle aspiration cytology guide the management of thyroid nodules. The aim of this audit was to evaluate the quality and adequacy of thyroid US reports with emphasis on the reporting of these pre-defined descriptors.
Methodology: A retrospective audit of thyroid US reports was undertaken at The James Cook University Hospital (JCUH) and University Hospital of North Tees (UHNT) between March 2012 and May 2013. All patients with a solitary thyroid nodule or a dominant nodule within a multi-nodular goitre on US were included. We audited the documentation of these predefined descriptors in each report.
Results: All of the 60 patient reports eligible were included. Documentation of micro-calcification and margins were the only 2 parameters present in >60% of reports across both sites. The documentation of the other parameters was variable and disparate between sites. Documentation of cervical lymph nodes and geneity was present in >80% of reports in JCUH but ≤50% in UNHT. The halo sign was the least documented parameter across both sites (<10%). Risk stratification was documented in 80% of JCUH reports and 43% of UHNT reports.
Conclusions: A significant proportion of thyroid US reports did not include descriptors of accepted radiological parameters that are essential in guiding further management of thyroid nodules. Reporting of both positive and negative findings was variable between the two sites and was operator dependent. Developing a standardised reporting proforma for thyroid nodules identified at US will help improve both the quality and consistency of reporting of solitary and dominant thyroid nodules.