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A JOINT STATEMENT FROM THE AMERICAN THYROID ASSOCIATION.

BACKGROUND
The American Thyroid Association, the European Association of Nuclear Medicine, the European Thyroid Association and the Society of Nuclear Medicine and Molecular Imaging have established an inter-societal working group to address the current controversies and evolving concepts in thyroid cancer management and therapy. The working group annually identifies topics that may significantly impact clinical practice and publishes expert opinion papers reflecting inter-societal collaboration, consensus, and suggestions for further research to address these important management issues.


SUMMARY
In 2019, the inter-societal working group identified the following topics for review and interdisciplinary discussion: 1) peri-operative risk stratification, 2) the role of diagnostic radioactive iodine imaging in initial staging and 3) indicators of response to radioactive iodine therapy.


CONCLUSIONS
The inter-societal working group agreed that: 1) initial patient management decisions should be guided by peri-operative risk stratification which should include the 8th edition AJCC system to predict disease specific mortality, the modified 2009 ATA risk stratification system to estimate structural disease recurrence, with judicious incorporation of molecular theranostics to further refine management recommendations ; 2) diagnostic radioactive iodine scanning in ATA intermediate risk patients should be utilized selectively rather than being considered mandatory or not necessary for all patients in this category; and 3) a consistent semi-quantitative reporting system should be used for response evaluations following RAI therapy until a reproducible and clinically practical quantitative system is validated.