EVALUATION OF MALIGNANT SOLID THYROID NODULES USING ULTRASOUND AND DOPPLER IMAGING

Ultrasonography (US) has emerged as the imaging modality of choice for evaluating thyroid diseases, particularly thyroid nodules, which are detected in 4%–8% of adults by palpation, 10%–41% by US, and up to 50% by histopathology at autopsy. The prevalence of thyroid nodules increases with age, yet most are benign, with malignancy rates ranging from 3% to 7%. Advances in high-resolution US have enabled the detection of small, non-palpable nodules that may otherwise remain unnoticed. Fine needle aspiration biopsy (FNAB) is commonly employed for suspicious nodules, and US-guided FNAB enhances diagnostic accuracy by targeting the solid portions of nodules and ensuring representative sampling. Although numerous studies since the late 1990s have examined the relationship between US features and malignancy risk, limitations remain in the specificity and sensitivity of these sonographic indicators. This underscores the ongoing need for careful US assessment and FNAB correlation in the evaluation of thyroid nodules to optimize early detection and management of thyroid malignancies.