Interpretation of the 2025 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and the 2025 American Thyroid Association Management Guidelines for Adult Patients with Differentiated Thyroid Cancer:progress in ultrasound,CT,MRI and ablation of thyroid nodules and differentiated thyroid cancer
10.19401/j.cnki.1007-3639.2025.09.002
- VernacularTitle:《2025版美国甲状腺学会成人甲状腺结节管理指南》及《2025版美国甲状腺学会成人分化型甲状腺癌管理指南》解读:甲状腺结节及分化型甲状腺癌超声、CT、MRI以及消融部分的进展
- Author:
Ruyu LIU
1
;
Chenyi WANG
;
Bo ZHANG
Author Information
1. 中国医学科学院北京协和医学院中日友好医院(中日友好临床医学研究所),北京 100029;中日友好医院超声医学科,北京 100029
- Publication Type:Journal Article
- Keywords:
Thyroid nodule;
Differentiated thyroid cancer;
American Thyroid Association guidelines;
Ultrasound;
Computed tomography;
Magnetic resonance imaging;
Ablation
- From:
China Oncology
2025;35(9):826-832
- CountryChina
- Language:Chinese
-
Abstract:
In 2025,the American Thyroid Association(ATA)divided the management of thyroid nodules and differentiated thyroid cancer(DTC)into two separate guidelines for the first time.This review highlighted the imaging-related updates and compared them with the 2015 ATA guidelines.The 2025 ATA guidelines introduce the following key updates:① Clarifying recommendations for screening of familial non-medullary thyroid cancer,and proposing that thyroid ultrasound screening is not recommended before treatment for patients who will receive glucagon-like peptide-1 receptor agonist(GLP-1 RA)therapy;② Refined the sonographic malignancy risk stratification system,enabling classification of all nodule types;③ Increasing size thresholds for fine-needle aspiration(FNA)and emphasized individualized decisions based on age,comorbidities and other factors;④ Follow-up intervals for nodules not meeting FNA criteria or with benign cytology have been adjusted,and clear ultrasound surveillance endpoints have been proposed;⑤ A standardized ultrasound protocol is established for active surveillance of cT1aN0M0 papillary thyroid cancer;⑥ Additional suspicious features,including abnormal blood flow in cervical lymph nodes,are introduced with quantitative evidence;⑦ Proposing dynamic risk stratification,adjusting follow-up intervals based on the patient's risk of residual lesion or disease recurrence and their response to treatment,and adding new endpoints for postoperative follow-up for low-risk DTC patients with sustained excellent response;⑧ Stressing the preoperative use of computed tomography(CT)or magnetic resonance imaging(MRI)to evaluate distant metastasis,while no longer recommending them as routine imaging tools during follow-up;⑨ Defining indications for thermal ablation:benign nodules,low-risk microcarcinomas and recurrent or metastatic lesions.Guided by evidence-based medicine,the 2025 ATA guidelines promote the transformation of thyroid ultrasound towards"precision,minimal invasiveness,individualization",providing a new paradigm for the whole-process clinical management of thyroid diseases.
