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Could nodule measurements be off depending on the person doing the work?
The old measurements were 1.6x,09x2.2, the new measurements are 1.6x1.2x2.1 so it has lost a mm in one direction. From the old scan, here is the following info. Mid-left thyroid lobe, solid/almost completely solid,Isoechoic to Hyperechoic, No microcalcifications, well-circumscribed, vascularity present.They were done at two different hospitals and my new Dr. did not see the old scans before making the decision for a FNA. This nodule was 3 on the Ti Rads scale and is the largest I have.
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You don't say how long it was between the 2 scans. Nodules can change size in a short period... Yours only lost 0.1 cm in the one direction, but gained 0.2 cm in another direction. I've had nodules that have completely disappeared, only to reappear later.
Many hospitals/imaging facilities don't use the TIRAD numbers, which really should be universal.
It's always best to make sure any new doctors have previous labs and/or scans with which to compare current data.
A greater than 2 cm nodule with vascularity should, typically, quality for FNA to be on the safe side.
Many hospitals/imaging facilities don't use the TIRAD numbers, which really should be universal.
It's always best to make sure any new doctors have previous labs and/or scans with which to compare current data.
A greater than 2 cm nodule with vascularity should, typically, quality for FNA to be on the safe side.
2 Comments
Thanks for the response, it was a year follow up
That's a pretty standard time for follow-ups and it's not unusual for nodules to change. I have a multi-nodular goiter and I had one nodule that disappeared and reappeared a couple of times. I even had one that my doctor and radiologists disputed for a couple of years - the radiologist said it was a solid nodule, the doctor said it was "just a shadow" - my question was: why would a shadow keep changing sizes/characteristics and cause pain all the time? That was a question the doctor was unable to answer - she's no longer my doctor...
Fortunately, few nodules turn out to be of concern. Please keep us posted on your progress.
Fortunately, few nodules turn out to be of concern. Please keep us posted on your progress.
Hi Jayramey,
Yes, the measurements can be off depending on who is doing the ultrasound or the radiologist's/doctor's reading of the ultrasound. I had a nodule that was 2.1 cm in the largest dimension on one ultrasound, then 2 weeks later at the ultrasound guided FNA the doctor/pathologist measured that nodule as 2.7 cm. I don't think it grew at all in between ultrasounds.
I am a little surprised the new doctor didn't compare the two scans to make an FNA decision (unless the decision is to do an FNA), since the reason for getting follow-up ultrasounds is to monitor how quickly (or slowly, or not at all) the nodule is growing.
The doctor may have looked at the size and decided FNA was needed because it is over 2 cm, because many places use 2cm for the current size threshold for FNA of thyroid nodules, even if it is a "low risk" nodule (which I would say yours fits that category based on isoechoic to hyperechoic and no calcifications). In that case, the decision might be FNA without even looking at the previous scan.
Good luck, especially if you need to do an FNA. Most thyroid nodules are benign (90-95%), and even if you need an FNA it does not mean your nodule is at a high risk for cancer - nothing you've described puts it above that 5-10% risk category.
Yes, the measurements can be off depending on who is doing the ultrasound or the radiologist's/doctor's reading of the ultrasound. I had a nodule that was 2.1 cm in the largest dimension on one ultrasound, then 2 weeks later at the ultrasound guided FNA the doctor/pathologist measured that nodule as 2.7 cm. I don't think it grew at all in between ultrasounds.
I am a little surprised the new doctor didn't compare the two scans to make an FNA decision (unless the decision is to do an FNA), since the reason for getting follow-up ultrasounds is to monitor how quickly (or slowly, or not at all) the nodule is growing.
The doctor may have looked at the size and decided FNA was needed because it is over 2 cm, because many places use 2cm for the current size threshold for FNA of thyroid nodules, even if it is a "low risk" nodule (which I would say yours fits that category based on isoechoic to hyperechoic and no calcifications). In that case, the decision might be FNA without even looking at the previous scan.
Good luck, especially if you need to do an FNA. Most thyroid nodules are benign (90-95%), and even if you need an FNA it does not mean your nodule is at a high risk for cancer - nothing you've described puts it above that 5-10% risk category.
1 Comments
Hello Sarahjogs. Thank you for the thorough answer ! I was thinking that he may have been recommending the FNA because it was over 2cm. I talked to the radiologist for this new scam and they didn’t even have the TI Rads numbers
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