2023 European Thyroid Association Clinical Practice Guidelines for thyroid nodule management

ETA · 2023 · Europe

Source and licence

Authors
Cosimo Durante, Laszlo Hegedüs, Agnieszka Czarniecka et al.
Title
2023 European Thyroid Association Clinical Practice Guidelines for thyroid nodule management
Journal
European Thyroid Journal, 2023
Licence
CC BY 4.0
Changes
Verbatim excerpts; formatting adapted

Full text retrieved 2026-10-27 from Europe PMC · PMC10448590

Licence statement of the original publication

This work is licensed under a Creative Commons Attribution 4.0 International License.

This page reproduces excerpts of the original publication; the original is authoritative. It has not been reviewed by a physician, does not state a recommendation of Medelix and does not replace medical advice. The guideline may have been updated since.

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Recommendations

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Abstract

With the widespread use of sensitive imaging techniques, which include neck visualization, a conspicuous number of thyroid nodules emerge and demand attention. Most lesions are benign, asymptomatic, and do not warrant treatment. In the case of cancer diagnosis, most are small, intrathyroidal and indolent neoplasms that can safely be managed conservatively. There is a pronounced need for more cost-effective, risk-adapted approaches to the management of this highly prevalent condition, taking the wishes of the patient into consideration. Thus, the present guidelines aim at providing a clinical practice guide for the initial workup and the subsequent management of adult individuals harboring thyroid nodules. Importantly, these guidelines are not intended to cover the management of thyroid malignancy. The manuscript and the specific recommendations were developed by reconciling the best available research evidence with the knowledge and clinical experience of the panelists and updating aspects of a number of previous European Thyroid Association guidelines.

Contents of the original publication

The section headings of the original.

  • Introduction
  • Methodology and grading of evidence
  • Initial evaluation
  • Thyroid ultrasound
  • Anatomical regions to be evaluated
  • Applying thyroid ultrasound in the evaluation of nodular thyroid disease
  • Complementary ultrasound techniques
  • Thyroid Imaging and Reporting Data System
  • Thyroid biopsy
  • Fine-needle aspiration
  • Core-needle biopsy
  • Wash-out thyroglobulin, calcitonin, and parathyroid hormone determination
  • Pathology
  • Cytopathology
  • Immunocytochemistry
  • Molecular diagnostics applied to cytology
  • Non-ultrasound imaging modalities
  • Thyroid scintigraphy
  • Other imaging modalities
  • Therapeutic options: non-surgical approaches
  • Clinical surveillance
  • Radioiodine therapy
  • Minimally invasive techniques
  • Therapeutic options: surgical approach
  • Diagnostic and therapeutic algorithm
  • Concluding remarks and future perspectives
  • Supplementary Materials

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