From the Research
TIRADS 3 thyroid nodules should be monitored with follow-up ultrasound in 1 year, as recommended by the most recent and highest quality study 1. This approach is based on the low risk of malignancy associated with TIRADS 3 nodules, which is approximately 13.3% as reported in the study 1. The monitoring schedule may be adjusted based on the nodule's size and ultrasound characteristics, as well as the patient's clinical symptoms and physical examination findings. Some key points to consider when monitoring TIRADS 3 nodules include:
- If the nodule remains stable at the 1-year follow-up, subsequent ultrasound should be performed in 1-2 years 1.
- After two stable ultrasounds, further routine surveillance is generally not necessary unless there are changes in clinical symptoms or physical examination findings.
- If during follow-up the nodule shows significant growth (generally defined as a 20% increase in two dimensions or a 50% increase in volume), develops new suspicious sonographic features, or if the patient develops concerning symptoms like hoarseness or difficulty swallowing, earlier reassessment or fine needle aspiration may be indicated 2, 3. The study by 1 provides the most recent and highest quality evidence for the management of TIRADS 3 thyroid nodules, and its recommendations should be prioritized in clinical practice. It's worth noting that other studies, such as 2, 4, 3, and 5, also provide valuable insights into the management of thyroid nodules, but the study by 1 is the most relevant and up-to-date. Overall, the monitoring approach for TIRADS 3 thyroid nodules should balance the need to detect potentially malignant changes while avoiding unnecessary procedures for what are most likely benign nodules.