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Giornata Mondiale Tiroide 2013 San Eugenio Roma
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Giornata Mondiale Tiroide 2013 San Eugenio Roma

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  • 1. Sant Eugenio - Rome, 25thMay 2013THYROID ULTRASOUND:THYROID ULTRASOUND:BLESSING OR CURSE?BLESSING OR CURSE?Massimiliano AndrioliEndocrinology, IRCCS, Istituto Auxologico Italiano, Milan
  • 2. PREAMBLE
  • 3. PREAMBLE
  • 4. PREAMBLE
  • 5. PREAMBLE
  • 6. PREAMBLE
  • 7. PREAMBLE• radiologists• endocrinologists• surgeons• otorhinolaryngologist• ginecologists• angiologistsTHYROID US PERFORMED BY:
  • 8. PREAMBLE
  • 9. EPIDEMIOLOGY• thyroid nodules very common• palpation prevalence (5 %)• US prevalence (67 %)
  • 10. EPIDEMIOLOGY
  • 11. • malignancy prevalence (5 %)• thyroid carcinoma incidence 1-2/100.000/year• increasing over the worldEPIDEMIOLOGY
  • 12. Davies, JAMA 2006• environmental influence• better detectionEPIDEMIOLOGY
  • 13. ?
  • 14. • size• internal content• shape• margins• echogenicity• calcifications• extracapsular relationship• vascularity• elasticityULTRASOUND FEATURES
  • 15. REQUIREMENTS FOR US TRAININGAACE Endocrine Certification in Neck US• theory program (US principles, neck anatomy,thyroid/parathyroid/lymph node pathology, FNA)• 100-125 studies/year (70% diagnostic, 30% FNA)• submit images/reportsAACE/AME/ETA THYROID NODULE GUIDELINES
  • 16. Italian Society of Ultrasound• Theory (20 h)• Tutorial practice (105 h) in a certified USschool: hospital/university/researchinstitute• 200 h (600 US) in private/hospital practiceAACE/AME/ETA THYROID NODULE GUIDELINES
  • 17. The panel suggest• at least 600 US/year• at least 30 cases thyroid tumor, recurrence,limph node metastasis/year• at least 70% thyroid tumors suspected at firstUS• at least 150 FNA/year, THY1 <10%AACE/AME/ETA THYROID NODULE GUIDELINES
  • 18. CONCLUSIONS• thyroid nodules: high prevalence;• thyroid cancers: increasing incidence;• better detection;• excessive detection;• standardized report;• dedicated examiners.
  • 19. Thanks for your attention …