🦋 Thyroid Nodule & TSH Suppression Simulator

Thyroid Nodule Detected on Ultrasound

Placeholder lead: nodule found, baseline sonographic traits recorded.

• ~50%: Nodule prevalence (placeholder: adults by high-res US)
• ~5–15%: Malignant fraction (placeholder: of evaluated nodules)
• 6: Key traits assessed (placeholder: composition to foci)
• US: Imaging modality (placeholder: grayscale + Doppler)

Baseline characteristics captured

Placeholder text: size, composition, echogenicity, shape, margin, foci noted.

TI-RADS Feature Scoring — Building the Point Total

Placeholder lead: five feature categories accumulate into one score.

• 2 pts: Composition max (placeholder: cystic to solid)
• 3 pts: Echogenicity max (placeholder: anechoic to very hypoechoic)
• 3 pts: Margin max (placeholder: smooth to extrathyroidal)
• 3 pts: Foci max (placeholder: none to punctate)

Point accumulation across categories

Placeholder text: each feature adds points toward the total score.

TSH Level Checked — Ruling Out an Autonomous Nodule

Placeholder lead: TSH distinguishes autonomous from typical nodules.

• 0.4–4.0: Normal TSH range (placeholder: mIU/L reference)
• Autonomy: Low TSH implies (placeholder: possible hot nodule)
• Scintigraphy: Next test if low (placeholder: radionuclide uptake scan)
• Low: Hot nodule cancer risk (placeholder: rarely malignant)

Why TSH changes the pathway

Placeholder text: suppressed TSH reduces biopsy priority for that nodule.

Management Pathway — Category × Size Threshold

Placeholder lead: category and size together set the next step.

• ≥25mm: TR3 biopsy threshold (placeholder: follow at ≥15mm)
• ≥15mm: TR4 biopsy threshold (placeholder: follow at ≥10mm)
• ≥10mm: TR5 biopsy threshold (placeholder: follow at ≥5mm)
• Not indicated: TR1–TR2 biopsy (placeholder: regardless of size)

Reading the decision matrix

Placeholder text: locate category row and size column for the action.

Outcome — Observation, Suppression, or Biopsy

Placeholder lead: final pathway balances sensitivity and biopsy burden.

• Minimize: Unnecessary biopsy goal (placeholder: avoid over-testing)
• Maximize: Cancer detection goal (placeholder: catch true malignancy)
• 1–2 yr: Routine follow-up interval (placeholder: repeat ultrasound)
• Selected cases: Suppression use (placeholder: benign nontoxic goiter)

Balancing sensitivity and burden

Placeholder text: pathway chosen to limit unneeded procedures.