Korean Journal of Radiology

The Korean Society of Radiology (대한영상의학회)
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Standardized Ultrasound Evaluation for Active Surveillance of Low-Risk Thyroid Microcarcinoma in Adults: 2024 Korean Society of Thyroid Radiology Consensus Statement

  • Ji Ye Lee (Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine) ;
  • Min Kyoung Lee (Department of Radiology, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Hyun Kyung Lim (Department of Radiology, Soonchunhyang University Seoul Hospital) ;
  • Chang Yoon Lee (Department of Radiology, Research Institute and Hospital, National Cancer Center) ;
  • Jin Yong Sung (Department of Radiology and Thyroid Center, Daerim St. Mary's Hospital) ;
  • Jung Hyun Yoon (Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine) ;
  • Soo Yeon Han (Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Jung Hee Shin (Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Ji-hoon Kim (Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine) ;
  • So Lyung Jung (Department of Radiology, St. Vincent's Hospital, The Catholic University of Korea) ;
  • Sae Rom Chung (Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center) ;
  • Jung Hwan Baek (Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center) ;
  • Dong Gyu Na (Department of Radiology, Gangneung Asan Hospital, Ulsan University College of Medicine) ;
  • Korean Society of Thyroid Radiology (KSThR) and Korean Society of Radiology (Korean Society of Thyroid Radiology (KSThR) and Korean Society of Radiology)
  • Received : 2024.09.03
  • Accepted : 2024.09.11
  • Published : 2024.11.01
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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.

Keywords

Acknowledgement

We would like to express our deepest gratitude to Dr. Young Joo Park and Dr. Eun Kyung Lee for their invaluable advisory role in the development of this guideline. Their expertise and guidance were instrumental in shaping the content of this work. We also extend our sincere thanks to Ms. Seou Kim for her outstanding efforts in creating the illustrations that significantly enhance the clarity and visual impact of this article.

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