Giornata Mondiale Tiroide 2013 San Eugenio Roma

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Giornata Mondiale Tiroide 2013 San Eugenio Roma

  1. 1. Sant Eugenio - Rome, 25thMay 2013THYROID ULTRASOUND:THYROID ULTRASOUND:BLESSING OR CURSE?BLESSING OR CURSE?Massimiliano AndrioliEndocrinology, IRCCS, Istituto Auxologico Italiano, Milan
  2. 2. PREAMBLE
  3. 3. PREAMBLE
  4. 4. PREAMBLE
  5. 5. PREAMBLE
  6. 6. PREAMBLE
  7. 7. PREAMBLE• radiologists• endocrinologists• surgeons• otorhinolaryngologist• ginecologists• angiologistsTHYROID US PERFORMED BY:
  8. 8. PREAMBLE
  9. 9. EPIDEMIOLOGY• thyroid nodules very common• palpation prevalence (5 %)• US prevalence (67 %)
  10. 10. EPIDEMIOLOGY
  11. 11. • malignancy prevalence (5 %)• thyroid carcinoma incidence 1-2/100.000/year• increasing over the worldEPIDEMIOLOGY
  12. 12. Davies, JAMA 2006• environmental influence• better detectionEPIDEMIOLOGY
  13. 13. ?
  14. 14. • size• internal content• shape• margins• echogenicity• calcifications• extracapsular relationship• vascularity• elasticityULTRASOUND FEATURES
  15. 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. 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. 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. 18. CONCLUSIONS• thyroid nodules: high prevalence;• thyroid cancers: increasing incidence;• better detection;• excessive detection;• standardized report;• dedicated examiners.
  19. 19. Thanks for your attention …

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