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

Ruyu LIU; Chenyi WANG; Bo ZHANG

doi:10.19401/j.cnki.1007-3639.2025.09.002

您当前的位置：

首页 >

文章列表页 >

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

Specialist's Commentary | 更新时间：2025-12-31

- 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
- China Oncology Vol. 35, Issue 9, Pages: 826-832(2025)
- 作者机构：
  
  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
  2. 中日友好医院超声医学科，北京 100029
  3. 国家呼吸医学中心，呼吸和共病全国重点实验室，国家呼吸疾病临床研究中心，中国医学科学院呼吸病学研究院，中日友好医院呼吸中心，北京 100029
- 作者简介：
- 基金信息：
  
  The Capital’s Funds for Health Improvement and Research(CFH-2024-2-4068)
- DOI：10.19401/j.cnki.1007-3639.2025.09.002
  CLC： R736.1
- Received：08 September 2025，
  
  Revised：2025-09-21，
  
  Published：30 September 2025
- 稿件说明：
移动端阅览
Ruyu LIU, Chenyi WANG, Bo ZHANG. 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[J]. China Oncology, 2025, 35(9): 826-832.
DOI：

Ruyu LIU, Chenyi WANG, Bo ZHANG. 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[J]. China Oncology, 2025, 35(9): 826-832. DOI： 10.19401/j.cnki.1007-3639.2025.09.002.

摘要

2025年美国甲状腺学会（American Thyroid Association，ATA）首次将甲状腺结节与分化型甲状腺癌（differentiated thyroid cancer，DTC）管理分为两部指南，对比2015版ATA指南的影像学部分，2025版ATA指南更新如下：① 明确对家族性非髓样癌筛查的建议，并提出使用胰高血糖素样肽-1受体激动剂（glucagon-like peptide-1 receptor agonist，GLP-1 RA）患者治疗前不建议进行甲状腺超声筛查；② 改进甲状腺结节超声恶性风险分层，实现全部结节可分类；③ 提高超声引导下细针抽吸活检（fine needle aspiration，FNA）径线阈值，强调参考年龄、合并症等个体化指标；④ 调整未穿刺结节及细胞学检查良性结节的随访周期，并提出超声随访终点；⑤ 明确cT1aN0M0甲状腺乳头状癌主动监测的标准化超声方案；⑥ 新增颈部可疑淋巴结异常血流及量化证据；⑦ 提出动态风险分层，根据患者病灶残留或疾病复发风险以及对治疗的反应调整随访周期，并新增持续疗效满意的低危DTC术后随访终点；⑧ 强调术前计算机体层成像（computed tomography，CT）或磁共振成像（magnetic resonance imaging，MRI）在评估远处转移方面的应用，而不再推荐CT或MRI作为术后常规随访的影像学手段；⑨ 提出热消融适应证包括良性结节、低危微小癌及复发或转移灶。2025版ATA指南影像学评估方面推荐意见更加明确，兼顾科学性、实用性及卫生经济学，为甲状腺结节和分化型甲状腺癌的全周期影像学管理提供了崭新范式。

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.

关键词

Keywords

references

HAUGEN B R , ALEXANDER E K , BIBLE K C , et al. 2015 American Thyroid Association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: the American Thyroid Association guidelines task force on thyroid nodules and differentiated thyroid cancer [J ] . Thyroid , 2016 , 26 ( 1 ): 1 - 133 . DOI: 10.1089/thy.2015.0020 http://doi.org/10.1089/thy.2015.0020

张波 , 徐景竹 , 吴琼 . 2015年美国甲状腺学会《成人甲状腺结节与分化型甲状腺癌诊治指南》解读: 超声部分 [J ] . 中国癌症杂志 , 2016 , 26 ( 1 ): 19 - 24 .

ZHANG B , XU J Z , WU Q . The interpretation of 2015 American Thyroid Association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: ultrasound part [J ] . China Oncol , 2016 , 26 ( 1 ): 19 - 24 .

SUSAN J M , LISA A O . American Thyroid Association management guidelines for adult patients with thyroid nodules: preview 2025 [R ] . Chicago : Annual Meeting of the American Thyroid Association , 2024 .

RINGEL M D , SOSA J A , BALOCH Z , et al. 2025 American Thyroid Association management guidelines for adult patients with differentiated thyroid cancer [J ] . Thyroid , 2025 , 35 ( 8 ): 841 - 985 .

KWON D , KULICH M , MACK W J , et al. Malignancy risk of thyroid nodules that are not classifiable by the American Thyroid Association ultrasound risk stratification system: a systematic review and meta-analysis [J ] . Thyroid , 2023 , 33 ( 5 ): 593 - 602 .

SINGH OSPINA N , MARAKA S , ESPINOSA DEYCAZA A , et al. Diagnostic accuracy of thyroid nodule growth to predict malignancy in thyroid nodules with benign cytology: systematic review and meta-analysis [J ] . Clin Endocrinol , 2016 , 85 ( 1 ): 122 - 131 . DOI: 10.1111/cen.12975 http://doi.org/10.1111/cen.12975

NI X F , XU S Y , ZHAN W W , et al. A risk stratification model for metastatic lymph nodes of papillary thyroid cancer: a retrospective study based on sonographic features [J ] . Front Endocrinol , 2022 , 13 : 942569 .

LEBOULLEUX S , SCHROEDER P R , BUSAIDY N L , et al. Assessment of the incremental value of recombinant thyrotropin stimulation before 2-[ 18 F ] -fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography imaging to localize residual differentiated thyroid cancer [J ] . J Clin Endocrinol Metab , 2009 , 94 ( 4 ): 1310 - 1316 . DOI: 10.1210/jc.2008-1747 http://doi.org/10.1210/jc.2008-1747

MONCHIK J M , DONATINI G , IANNUCCILLI J , et al. Radiofrequency ablation and percutaneous ethanol injection treatment for recurrent local and distant well-differentiated thyroid carcinoma [J ] . Ann Surg , 2006 , 244 ( 2 ): 296 - 304 . DOI: 10.1097/01.sla.0000217685.85467.2d http://doi.org/10.1097/01.sla.0000217685.85467.2d

SHIN J E , BAEK J H , LEE J H . Radiofrequency and ethanol ablation for the treatment of recurrent thyroid cancers: current status and challenges [J ] . Curr Opin Oncol , 2013 , 25 ( 1 ): 14 - 19 .

NA D G , LEE J H , JUNG S L , et al. Radiofrequency ablation of benign thyroid nodules and recurrent thyroid cancers: consensus statement and recommendations [J ] . Korean J Radiol , 2012 , 13 ( 2 ): 117 - 125 . DOI: 10.3348/kjr.2012.13.2.117 http://doi.org/10.3348/kjr.2012.13.2.117

Views

664

下载量

CSCD

Alert me when the article has been cited

提交

Tools

Publicity Resources

Research progress on the correlation between imaging features and the molecular subtype, histopathology, clinical prognosis of ductal carcinoma in situ of the breast

A case report of pulmonary malignant melanoma complicated with lung adenocarcinoma and literature review

The interpretation of 2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer: Surgery part

Interpretation of the 2025 American Thyroid Association Management Guidelines for Adult Patients with Differentiated Thyroid Cancer: progress in external beam radiotherapy (EBRT) for differentiated thyroid cancer

Interpretation of the 2025 American Thyroid Association Management Guidelines for Adult Patients with Differentiated Thyroid Cancer: perioperative assessment and management of parathyroid function and precision individualized management of postoperative TSH suppression in adults with differentiated thyroid cancer

Related Author

Qi LIU

Cai CHANG

Jiawei LI

胡冠男

陈　雷

周良平

周正荣

李小毅

Related Institution

Department of Ultrasound Medicine, Fudan University Shanghai Cancer Center, Department of Medical Oncology, Shanghai Medical College, Fudan University

复旦大学附属肿瘤医院放射科，复旦大学上海医学院肿瘤学系

复旦大学附属肿瘤医院闵行分院放射科

中国医学科学院北京协和医院基本外科

Department of Radiation Oncology, Peking Union Medical College Hospital & Chinese Academy of Medical Sciences

AI问答

⁰

DOI：10.19401/j.cnki.1007-3639.2025.09.002

摘要

Abstract

关键词

Keywords

references