Thyroid & Parathyroid Ultrasound: TIRADS & Beyond
ACR TI-RADS scoring, parathyroid localisation, elastography & ultrasound-guided FNA technique
Course Overview
This module provides a comprehensive update on thyroid and parathyroid ultrasound, incorporating the ACR TI-RADS classification system alongside practical guidance on nodule characterisation, elastography, and ultrasound-guided fine needle aspiration. Participants will develop a systematic approach to thyroid nodule assessment that aligns with current international guidelines.
The parathyroid component covers the ultrasound localisation of parathyroid adenomas in the context of primary hyperparathyroidism, including ectopic gland identification and the integration of ultrasound with sestamibi scintigraphy. The module concludes with a practical session on FNA technique, adequacy assessment, and specimen handling.
Learning Outcomes
- Apply ACR TI-RADS criteria to classify thyroid nodules and guide management decisions
- Characterise thyroid nodule composition, echogenicity, shape, margin, and echogenic foci
- Use elastography to complement greyscale assessment of thyroid nodules
- Localise parathyroid adenomas using systematic ultrasound technique
- Identify ectopic parathyroid glands and correlate with biochemical findings
- Perform and document ultrasound-guided thyroid FNA to standard technique
Curriculum
Thyroid Anatomy & Normal Variants
- Thyroid gland anatomy
- Normal variants and pitfalls
- Diffuse thyroid disease patterns
ACR TI-RADS Classification
- Five TI-RADS features
- Point scoring and category assignment
- Management recommendations by category
Elastography & Advanced Techniques
- Strain and shear wave elastography
- Elastography in nodule characterisation
- CEUS for indeterminate nodules
Parathyroid Localisation
- Normal and abnormal parathyroid anatomy
- Adenoma vs hyperplasia
- Ectopic gland identification
Ultrasound-Guided FNA
- FNA technique and needle selection
- Adequacy assessment
- Reporting and Bethesda classification
Prerequisites
- General ultrasound experience
- Basic neck anatomy knowledge
- No prior thyroid scanning experience required
Assessment
Online MCQ examination (70% pass mark) + TI-RADS case classification exercise