The Joint Annual Scientific Meetings of the Endocrine Society of Australia and the Society for Reproductive Biology 2018

Follow-up of incidental thyroid nodules detected on computed tomography angiography of the head and neck (#235)

Miriam E Koome 1 , Rahul Barmanray 2 , Winnie Ho 3 , Bernard Yan 4 , Mark Pace 5
  1. Royal Melbourne Hospital, Parkville, Victoria, Australia
  2. Endocrinology, Western Health, Melbourne, Victoria, Australia
  3. Western Health, Melbourne, VIC
  4. Melbourne Brain Centre, Melbourne, Victoria, Australia
  5. Endocrinology, Royal Melbourne Hospital, Parkville, Victoria, Australia

Background: The detection of an incidental thyroid nodule is a common clinical scenario. Due to their potential for malignancy, the follow-up of thyroid nodules is important.

Aims: This study aimed to determine the prevalence of thyroid nodules identified on computed tomography angiography (CTA) of the head and neck performed at a single centre and the extent of follow-up organised by treating clinicians as well as the factors that influenced this.

Methods: The radiological reports for inpatient CTA head and neck scans performed in 2016 at a single high-volume metropolitan tertiary stroke centre at which endovascular clot retrieval is performed were screened for mention of thyroid nodules. The medical records of patients in whom thyroid nodules were detected were reviewed to collect demographic data and determine what thyroid nodule follow-up, if any, was organised. Exclusion criteria were a previously established diagnosis of thyroid nodular disease or other thyroid pathology, death, or the absence of a discharge summary.

Results: Of 1,240 CTA head and neck scans performed during the study period, 95 patients with thyroid nodules were identified (7.7% prevalence). After applying the exclusion criteria, 69 patients were included in the analysis. Of these, 13 (18.8%) had some form of thyroid nodule follow-up organised. Factors significantly associated with follow-up included lower comorbidity status, specification of the size of the nodule in the radiological report, and mention of the thyroid nodule in the conclusion of the radiological report.

Conclusions: Follow-up of incidental thyroid nodules in this population was suboptimal. However, it appears that the way in which these findings are communicated in radiological reports can influence the likelihood of follow-up, which represents an opportune target for improvement.