The study included 556 patients who underwent thyroid surgery at a single institution in China between January and September 2016, and had complete data available. Wu H et al 2018 Echogenic foci with comet-tail artifact in resected thyroid nodules: not an absolute predictor of benign disease. The goal of this study was to evaluate the frequency and types of bright spots with comet-tail present in cancerous and non-cancerous thyroid nodules removed surgically. However, the significance of the small bright spots with comet-tail is not completely evaluated. In particular, small bright spots with a feature known as a comet tail are usually associated with a benign thyroid nodule. However, not all small bright spots noted on ultrasound represent microcalcifications. For example, up to 95% of thyroid nodules with small bright spots known as microcalcifications are cancerous. Several thyroid nodule features noted on ultrasound are suggestive of thyroid cancer.
According to the American Thyroid Association guidelines, all patients with thyroid nodules should undergo ultrasound evaluation to evaluate their cancer risk and decide whether a thyroid biopsy is indicated. The best imaging method for evaluation of thyroid nodules is ultrasound. Endocrine Certification in Neck Ultrasound Program, American Association of Clinical Endocrinologists.The American Association of Clinical Endocrinologists offers basic and advanced courses as well as a certification program in endocrine neck ultrasound. I strongly encourage any thyroidologists who are not already performing their own ultrasounds but are interested in doing so to seek further experience and training. The results of ultrasound are dependent on both the operator and the interpreter. To avoid this error, thyroid ultrasound should be performed and interpreted by clinicians who are not only skilled in ultrasound technique and knowledgeable about thyroid disease but who are also familiar with the unique history and presentation of each patient. I have frequently seen echogenic foci with comet tail artifact incorrectly called “microcalcifications.” Sometimes, those who are unfamiliar with thyroid ultrasonography misinterpret what type of echogenic foci a patient has. Repas, DO, FACP, FACE, CDEīecause the presence of such findings may raise or lower one’s concern for possible cancer, it is essential for the presence of these to be noted on ultrasound reports. Comet tail artifact appears as a bright echogenic line with an echogenic triangle or lines reverberating posterior to it. In contrast, the risk for malignancy when a nodule had macrocalcification was 4%, while the risk when there was microcalcification was 31%.įigure 1. In a study by Beland et al, no thyroid nodules with bright echogenic linear foci with or without comet tail were malignant. Macrocalcification can be distinguished from microcalcifications and comet tail artifact because they are larger and there is posterior shadowing.Ĭomet tail artifact appears as a bright echogenic line with an echogenic triangle or lines reverberating posterior to it (See image below). Some have called this the “starry sky at night” because of this twinkling appearance. As the ultrasound probe is moved back and forth, microcalcifications come in and out of view. They are often more readily seen while performing ultrasound in real-time and often less obvious on still images. Microcalcifications are tiny and without posterior shadowing. Some echogenic foci such as microcalcifications are associated with increased risk for malignancy, while others such as comet tail artifact are associated with low risk.
If you continue to have this issue please contact to HealioĮchogenic foci are commonly identified on thyroid ultrasound.
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