OBJECTIVE: We assessed the number of inappropriate thyroid ultrasound(US) scans performed, the quality of radiology reporting for thyroid nodules and the resultant number of thyroid cancers identified.
MATERIALS AND METHODS: Data was collected retrospectively for the period of July 2014 and July 2017. Data for 251 patients who had thyroid US scans and the final 201 patients with thyroid nodules were evaluated using descriptive statistics. Indications for thyroid US imaging amongst referring clinicians were assessed. We also compared radiology reporting practices of thyroid nodules to the published 2009 and 2015 American Thyroid Association(ATA) guidelines.
RESULTS: There were 50.2% of patients with initial thyroid US imaging deemed outside of expert recommendations including 46% of cases for hypothyroidism, 39.7% for hyperthyroidism and 14.3% for neck pain. Definite recommendation whether to further evaluate thyroid nodules were provided in 44.8% of radiology reports. There were no radiology reports that described thyroid nodules findings based on patterns as recommended by the 2015 ATA guidelines. Two cases of thyroid cancer were detected including one patient with a previous history of thyroid cancer and one patient with hypothyroidism.
CONCLUSION: Routine use of US thyroid imaging outside expert recommendation is common. There is lack of standardised reporting when assessing thyroid nodules on US. The appropriate utilisation of US imaging when investigating thyroid pathology and systematic reporting according to the 2017 guidelines published by the American College of Radiology Thyroid Imaging Reporting and Data System (ACR TI-RADS) may reduce unnecessary investigations for thyroid nodules in the future.