So far, seminars 1 and 2 are so informative easily broken down with excellent information. I am newly diagnosed with 2 Tirads 4&5, and these seminars have truly made me understand exactly what is in my thyroid. I'm getting ready to watch part 3. I'm so grateful and feel confident in understanding what I have. I go for my FNA in 3 days. If anyone hasn't watched all 3, please do so. They truly are worth your time.
Thanks for explaining a lot of this. I have a .9 cm nodule that is TR4 and if it were only 1 mm larger, it sounds like it would be referred for biopsy. It is cystic and solid. So, I was a bit shocked to read my report yesterday in my patient portal that they don't even recommend follow up. What if it gets larger? My ENT seemed like he had an eye to remove it and biopsy it first. My primary care went and ordered the ultrasound since the FNA wasn't being scheduled anyway. The only reason I found it was because I saw it while talking to my mother, who was cutting a piece of hair, while I stood in front of the mirror. It doesn't seem exactly right that I just ignore it and don't follow up with anyone, if that is what the radiology report really suggests. The nodule actually seemed to go down in size and is less visble by now, but maybe because it has less fluid in it. On the US, it was even a mm larger than on the original CT scan. And it is in the Isthmus. I'm going to see what either doctor suggests for follow up. I don't actually like the idea of just ignoring a "moderately suspicious" nodule in the Isthmus in particular. At least I can feel it and see it, though.
If it would be 1 mm larger, it would have indication for ultrasound follow-up, not FNA. Even if the nodule gets larger, it would have to grow another 6 mm to be admissible for biopsy. And still the vast majority of those nodules will be benign. Ultrasound is more reliable on giving an accurate measurement of the nodule compared to CT, so the 1 mm difference between techniques is irrelevant. Don't get too caught up on the "moderately suspicious". An ACR TI-RADS 3 nodule with 25 mm is labeled as "mildly suspicious" due to being a TR3, but it's more suspicious than an ACR TI-RADS 4 with 0.9 cm, and that's why it warrants a biopsy, and the latter doesn't. Follow-up of small thyroid nodules creates unnecessary anxiety on patients and burden on the health system. They're far too frequent and most often have no clinical relevance, so it's unthinkable to just follow-up everything. Also, FNAs can have complications, so we only want to do an FNA when the patient can really benefit from it.
@simba1608 I've listened to part one and 2 on my way to 3. I found your comment very informative as well. I do go for my FNA on Monday. I have 2 nodules one is tirads 4 solid hypoechoic they said follow up 12 mo. They are doing the biopsy Monday on the Tirads 5 it's 2.5 cm solid. Any tips for the FNA? My first time and I'm wondering when it's solid how does that needle go in it? 😂 Appreciate your comment it excellent in explaining
@@AnneMarieBibby1966 Hi. There's not many tips I can give. The doctor will explain the procedure, which is usually very straightforwad, although it depends of course from patient to patient. The needle for the FNA is very thin, and usually no local anesthesia is needed, because the more painful part is the insertion of the needle through the skin. After that, you may feel something moving inside, but it's usually not painful. The needle goes through the solid nodule as it goes through the rest of the tissues. If the walls of the nodule are calcified, it's harder to get the needle inside, but it probably is not the case, otherwise you would know from the report (and it's less frequently so). I hope everything goes well.
@simba1608 Thank you I appreciate you taking the time to answer me. My report didn't mention calcification on the wall. Only solid hypoechoic wider then tall, lower left pole and punctate echogenic foci. All of this is so interesting. I never knew how important our thyroid function is. Thank you so much..
@@simba1608 I somehow missed this comment until Anne replied to it. I was referred to an endocrinologist who followed it with ultrasound. He suggested we just watch it and that it wold be a difficult biopsy to do if it were larger, based on how it was situated. Over the course of nearly two years, it diminished and then went away. I am glad I had follow up, though.
If a nodule is TR5, but less than 1cm, it shouldn’t be followed up.. But what happens if there’s another nodule that is being followed and another ultrasound is done a year later.. should the sonographer disregard that small nodule because it didn’t need follow up, or should they document it based on the tirads score?
So far, seminars 1 and 2 are so informative easily broken down with excellent information. I am newly diagnosed with 2 Tirads 4&5, and these seminars have truly made me understand exactly what is in my thyroid. I'm getting ready to watch part 3. I'm so grateful and feel confident in understanding what I have. I go for my FNA in 3 days.
If anyone hasn't watched all 3, please do so. They truly are worth your time.
Thanks for explaining a lot of this. I have a .9 cm nodule that is TR4 and if it were only 1 mm larger, it sounds like it would be referred for biopsy. It is cystic and solid.
So, I was a bit shocked to read my report yesterday in my patient portal that they don't even recommend follow up. What if it gets larger? My ENT seemed like he had an eye to remove it and biopsy it first.
My primary care went and ordered the ultrasound since the FNA wasn't being scheduled anyway. The only reason I found it was because I saw it while talking to my mother, who was cutting a piece of hair, while I stood in front of the mirror.
It doesn't seem exactly right that I just ignore it and don't follow up with anyone, if that is what the radiology report really suggests. The nodule actually seemed to go down in size and is less visble by now, but maybe because it has less fluid in it. On the US, it was even a mm larger than on the original CT scan. And it is in the Isthmus.
I'm going to see what either doctor suggests for follow up. I don't actually like the idea of just ignoring a "moderately suspicious" nodule in the Isthmus in particular. At least I can feel it and see it, though.
If it would be 1 mm larger, it would have indication for ultrasound follow-up, not FNA.
Even if the nodule gets larger, it would have to grow another 6 mm to be admissible for biopsy. And still the vast majority of those nodules will be benign.
Ultrasound is more reliable on giving an accurate measurement of the nodule compared to CT, so the 1 mm difference between techniques is irrelevant.
Don't get too caught up on the "moderately suspicious". An ACR TI-RADS 3 nodule with 25 mm is labeled as "mildly suspicious" due to being a TR3, but it's more suspicious than an ACR TI-RADS 4 with 0.9 cm, and that's why it warrants a biopsy, and the latter doesn't.
Follow-up of small thyroid nodules creates unnecessary anxiety on patients and burden on the health system. They're far too frequent and most often have no clinical relevance, so it's unthinkable to just follow-up everything. Also, FNAs can have complications, so we only want to do an FNA when the patient can really benefit from it.
@simba1608 I've listened to part one and 2 on my way to 3.
I found your comment very informative as well.
I do go for my FNA on Monday. I have 2 nodules one is tirads 4 solid hypoechoic they said follow up 12 mo.
They are doing the biopsy Monday on the Tirads 5 it's 2.5 cm solid. Any tips for the FNA? My first time and I'm wondering when it's solid how does that needle go in it? 😂
Appreciate your comment it excellent in explaining
@@AnneMarieBibby1966 Hi. There's not many tips I can give. The doctor will explain the procedure, which is usually very straightforwad, although it depends of course from patient to patient. The needle for the FNA is very thin, and usually no local anesthesia is needed, because the more painful part is the insertion of the needle through the skin. After that, you may feel something moving inside, but it's usually not painful. The needle goes through the solid nodule as it goes through the rest of the tissues. If the walls of the nodule are calcified, it's harder to get the needle inside, but it probably is not the case, otherwise you would know from the report (and it's less frequently so). I hope everything goes well.
@simba1608 Thank you I appreciate you taking the time to answer me. My report didn't mention calcification on the wall. Only solid hypoechoic wider then tall, lower left pole and punctate echogenic foci.
All of this is so interesting. I never knew how important our thyroid function is.
Thank you so much..
@@simba1608 I somehow missed this comment until Anne replied to it. I was referred to an endocrinologist who followed it with ultrasound. He suggested we just watch it and that it wold be a difficult biopsy to do if it were larger, based on how it was situated. Over the course of nearly two years, it diminished and then went away. I am glad I had follow up, though.
Webinar starts at 5:15
If a nodule is TR5, but less than 1cm, it shouldn’t be followed up.. But what happens if there’s another nodule that is being followed and another ultrasound is done a year later.. should the sonographer disregard that small nodule because it didn’t need follow up, or should they document it based on the tirads score?
They should document it, describe it, atribute a TI-RADS score, and evaluate if there's been any progression in size to warrant follow-up or FNA.