Dr.Guttler’s Patient Thyroid Blog Post: The Gold Standard Thyroid Nodule Evaluation: How to have the best chance to avoid surgery.

Dr.Guttler’s Patient Thyroid Blog Post: The Gold Standard Thyroid Nodule Evaluation: How to have the best chance to avoid surgery.

1. Endocrine evaluation, TSH,FT4,TPO, TIRADS Ultrasound, FNA.

2. Low risk ultrasound and Class II cytology. With symptoms or cosmetic issues RFA is the treatment of choice not surgery. Large benign cysts are treated with ethanol.

3. Class III or IV nodules need further evaluation. molecular markers are needed. A benign classifier also means no surgery and symptomatic nodules can be treated with Ethanol or RFA.

4. A negative PET/CT with no uptake in the nodule is another cancer rule out with a 40% reduction in exploratory surgery

5. Micropapillary small cancer can be treated by active surveillance or RFA.

thyroid.manager@thyroid.com

DR.G.