Ultrasound is critical in detection, diagnosis, and management of thyroid nodules. Ultrasound detection of regional nodal metastatic disease is based on abnormal nodal morphology rather than size and is critical to initial surgical and long-term management of thyroid cancer. Fine-needle aspiration biopsy is the gold standard for malignancy diagnosis in thyroid cancer. Thyroglobulin assay of nodal aspirates improves accuracy in diagnosis of metastases. Reporting lexicons assign risk levels to thyroid nodules with the goal of improving and standardizing patient management. Surveillance ultrasound in papillary microcarcinomas is being evaluated and compared with surgical management.
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