Assessment of Echogenicity of Thyroid Nodules

Dear Editor,

We read with interest the article by Dr. Bojunga in Ultraschall in der Medizin entitled “Ultrasound for Thyroid Nodules” [1]. This is a well-written and clearly structured education article. However, there is one statement that needs clarification. On pages 490 and 491, the author explains that “echogenicity is subdivided into hyperechoic, isoechoic, hypoechoic as well as distinctly hypoechoic, in each case related to the striated neck muscles”. In our opinion, this is not correct and only applies for the distinction of (moderate) hypoechoic (for example TIRADS 4) to distinctly hypoechoic (for example TIRADS 5) lesions [2]. In the captions, for example for figure 2, the author even clearly compares the echogenicity of the isoechoic nodule to the surrounding thyroid parenchyma and not to the neck muscles.

Yours sincerely,
Holger M. Strunk, MD
Milka Marinova, MD, PHD

• References

• 1 Bojunga J. Ultrasound of Thyroid Nodules – Sonografie von Schilddrüsenknoten. Ultraschall in Med 2020; 41: 488-511 . doi:10.1055/a-0659-2350
• 2 Russ G, Bonnema SJ, Erdogan MF. et al. European Thyroid Association Guidelines for Ultrasound Malignancy Risk Stratification of Thyroid Nodules in Adults: The EU-TIRADS. Eur Thyroid J 2017; 6: 225-237 . doi:10.1159/000478927