Why the European Association of Nuclear Medicine has declined to endorse the 2015 American Thyroid Association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer.

Abstract

Recently the American Thyroid Association (ATA) released the third version of one of the most cited differentiated thyroid cancer (DTC) guidelines under the title B2015 American Thyroid Association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer^ [1]. Compared to the earlier versions [2, 3], these guidelines are a major departure, as the volume of the text, the number of recommendations and the number of references have increased considerably. We fully understand the effort involving many hours of work that must have been required for the rigorous screening of the literature to produce the evidence tables and the eventual definitions of the recommendations. The document consists of roughly 73,000 words which make up the 101 recommendations and the explanatory text and comments. In the current ATA guidelines, most of the text appears eminently sensible and represents a significant advance from previous DTC-related guidelines published by the ATA as well as other societies, including the 2008 European Association of Nuclear Medicine (EANM) guidelines on I therapy of DTC [4–7]. For instance, we welcome the clear division of indications for initial I treatment of DTC patients after total thyroidectomy into ablation, adjuvant therapy and therapy. Furthermore, this change in terminology which we strongly support much more clearly delineates the role of I in the care of patients with DTC in other disciplines, especially medical oncology. Considering all the factors that have to be weighed in formulating recommendations this is a huge dedicated effort that has come to fruition.