Endocrine Abstracts

JOINT2248

Introduction: There is a high prevalence of thyroid nodules (up to 60%) in adults in the general population. 2023 European Thyroid Association clinical practice guidelines for thyroid nodule management recommends neck Ultrasound (US) assessment with European Thyroid Imaging and Reporting Data System (EU-TIRADS) and thyroid function testing (TFT) in evaluation of thyroid nodules. This study aims to assess US classification and TFT evaluation of thyroid nodules in our centre.

Methods: A retrospective data of all US thyroid scans performed in our hospital in 2024, were included in the study. TFT results of persons with thyroid nodules on US scans, were collected from the hospital laboratory system.

Results: A total of 230 US thyroid scans from 2024 were reviewed. Mean age of people who had US thyroid was 54.7±21.2 years. 82% were female and 18% were male. 36 scans (16%) had no thyroid nodules, while 194 scans (84%) showed at least one nodule. TIRADS was used in categorizing thyroid nodules in 62 out of 194 scans (32%); U classification was used in 52 scans (27%) and no categorization of thyroid nodules in 80 scans (41%). In US thyroid scans with TIRADS categorization, 42 were TIRADS 2 (benign); 23 were TIRADS 3 (mild suspicion); 3 were TIRADS 4 (Moderate to high suspicion); 2 were TIRADS 5 (high risk). Of US thyroid scans with U classification, 45 were classified as U2 (benign), 23 as U3 (indeterminate/uncertain), and two as U4 (suspicious), with no reports classified as U5 (highly suspicious/malignant). 38 out of 194 US thyroid reports (19.6%) had recommendations to repeat the US thyroid in 6 or 12 months to re-evaluate thyroid nodules and 23 reports (11.9%) had recommendations to refer for fine needle aspiration. On reviewing the laboratory system, TFT results were available in 142 persons out of 194 with thyroid nodules (73%). Out of 142 with TFT results, 119 (83.8%) had normal TFTs, 11 (7.7%) had hypothyroidism and 12 (8.5%) had hyperthyroidism.

Conclusion: Our study demonstrated the majority of thyroid nodules that were categorised, are considered benign or of low suspicion, and a significant proportion of people with thyroid nodules have euthyroid status. Our audit also showed there is some variability in thyroid nodule categorization, with 41% of nodules unclassified. The local practice guidelines on standardised categorization of thyroid nodule management and TFTs, could improve consistency, aiding clinical decisions on follow-up, individualised management and resources allocation.