Abstract
Thyroid nodules frequently are encountered incidentally, and although thyroid nodules are common, the prevalence of thyroid malignancy is relatively low. Considerable overlap exists between the appearance of benign and malignant thyroid nodules. Also, the varying guidelines among scientific associations, regarding when biopsy of a thyroid nodule is recommended, create a growing diagnostic dilemma. The initial approach to differentiate benign from malignant thyroid nodules focused on pattern recognition with a recent shift to individual feature analysis by ultrasound. Ultimately, fine-needle aspiration is required for definitive diagnosis; however, it is unrealistic to biopsy every thyroid nodule. The objective of this article is to emphasize the use of both pattern recognition and individual feature analysis to appropriately select candidates for biopsy and follow-up with a goal of identifying clinically significant thyroid cancer and of avoiding unnecessary workup of benign thyroid nodules.
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