nodules

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1. At what size in cm or mm should thyroid nodules biopsy be done in an average adult male? 2. Can a small hypoechoic nodules (<6mm)within each lobe of the thyroid gland be indetified on 123 or I 131 tests?If yes which of the above 2 tests is better in doing so,which should be used and why? 3. What's a(<6mm)small hypoechoic nodules normal interval change in a 6 months and a year by ultrasound measurement? 4. What's a thyroid small nodules <6mm expected ultrasound margin of error meaurement in mm in a 6 months and a year in average adult male?5.When a one small nodule (5-6mm)is indetified within each lobe of the thyroid gland by ultrasound what other tests should be done?6.What's a thyroid nodule smallest size in mm that I 123 or I 131 tests can detect? 7. If adult male person had a normal I 131 test 25 plus years ago (to rule out hyperthyroid)does this means he did not have thyroid nodules at that time,had them but they were less <5mm and thus undetectable or it was just not witten on report? 8. Does it often happen when person had a small thyroid nodules <5mm for more than 25 years and did not know that he had it until he had carotid artery duplex test,CT or MRI of the neck for other conditions(incidental findings)and as result than found out that he had thyroid small nodules? 9. Can small thyroid nodules 5-6mm in size be detected by cervical MRI? 10.Do 2 small thyroid nodules 5-6mm in size in otherwise normal thyroid gland cause irregular heart beats? Thank you

[Mark Lupo, M.D.]

1. >10mm usually
2. No scan is indicated unless the TSH is low.  
3. Usually stable in size or slight increase
4. user dependent - if done by same tech/MD - should be <5%
5. TSH & repeat US in 6 months
6. Not certain, I-123 is not indicated for most nodule eval and likely would not show anything less than 5mm.
7. Tough to know -- likely no nodules were seen
8. Very common - probably up to 20% of adult men may have this
9. Depends on MRI slicing protocol -- if <5mm slices, yes
10. No,not if thyroid function normal.