Available online 26 November 2025, 501659

Author links open overlay panel, , , , , , AbstractIntroduction

Before 2014, few Endocrinology and Nutrition Departments nationwide routinely used cervical ultrasound. Following the training activities promoted by the Thyroid Pathology Imaging Group, it is important to evaluate the current level of implementation of ultrasound and ultrasound-guided techniques in clinical practice.

Material and methods

A structured, self-administered survey was designed and sent electronically to hospitals throughout the country.

Results

Responses were received from a total of 101 hospitals. Ninety-three percent of the departments surveyed reported routine use of ultrasound in clinical practice, with specialized consultations in 71% of cases. Sixty percent performed fine-needle aspiration cytology, and 55% performed staging and follow-up of differentiated thyroid cancer. Among minimally invasive techniques (MIT), 42% of centers perform enolization of thyroid cysts and 12% offer thermal ablation techniques, with radiofrequency being the most commonly used modality. Eighty-six% of professionals have received training through the Applied Imaging Techniques for Thyroid Pathology Group of the SEEN (National Institute of Endocrinology and Nutrition). Currently, 56 centers offer specific ultrasound training for medical residents in the specialty.

Conclusion

Over the last decade, ultrasound has been widely implemented in the Endocrinology and Nutrition Departments affiliated with the SEEN, including the incorporation of ultrasound-guided techniques into routine practice. However, the use of MIT such as thermal ablation is still limited, so it is considered necessary to strengthen both specific training and institutional support to promote its maximum implementation.

ResumenIntroducción

Antes del año 2014, pocos Servicios de Endocrinología y Nutrición a nivel nacional empleaban de forma rutinaria la ecografía cervical. Tras las actividades formativas promovidas por el Grupo de Imagen en Patología Tiroidea, resulta relevante evaluar el grado actual de implementación de la ecografía y de las técnicas ecoguiadas en la práctica clínica.

Material y métodos

Se diseñó una encuesta estructurada, autoadministrada, que fue remitida por vía electrónica a hospitales distribuidos por todo el territorio nacional.

Resultados

Se recibieron respuestas de un total de 101 centros hospitalarios. El 93 % de los servicios encuestados refieren utilizar la ecografía de forma habitual en la práctica clínica, con consultas monográficas en el 71 % de los casos. Un 60 % realiza citología mediante punción con aguja fina y un 55 % lleva a cabo estadiaje y seguimiento del cáncer diferenciado de tiroides. Entre las técnicas mínimamente invasivas (TMI), el 42 % de los centros practica la enolización de quistes tiroideos y un 12 % dispone de técnicas de ablación térmica, siendo la radiofrecuencia la modalidad más utilizada. El 86 % de los profesionales ha recibido formación proporcionada a través del Grupo de Técnicas de Imagen Aplicadas a la patología tiroidea de la SEEN. Actualmente, 56 centros ofrecen formación específica en ecografía para médicos residentes de la especialidad.

Conclusión

Durante la última década, se ha producido una amplia implantación de la ecografía en los Servicios de Endocrinología y Nutrición vinculados a la SEEN, incluyendo la incorporación de técnicas ecoguiadas en la práctica habitual. No obstante, la utilización de TMI como la ablación térmica aún es limitada, por lo que se considera necesario reforzar tanto la formación específica como el soporte institucional para favorecer su máxima implementación.

Introduction

Cervical ultrasound is currently a fundamental imaging modality for the study of thyroid disease, both benign and malignant.1 It is the reference method for the evaluation of thyroid nodules and enables ultrasound-guided fine-needle aspiration (FNA). Its use facilitates preoperative mapping in thyroid cancer and the detection of recurrences during follow-up.2 In addition, ultrasound allows assessment of the size, morphology, and vascularization of the thyroid gland. In recent years, ultrasound-guided minimally invasive techniques (MIT)—such as chemical or thermal ablation—have been developed, safely and efficiently reducing the number of thyroidectomies.3

Until 2014, very few endocrinology and nutrition departments in Spain had ultrasound machines, so ultrasound studies were performed in central radiology departments, and FNA was carried out blindly by palpation. From that date onward, an increasing number of endocrinology departments incorporated ultrasound machines and, after specific training, implemented ultrasound examinations in clinical practice, as well as ultrasound-guided FNA and later MIT procedures. With the endorsement of the Spanish Society of Endocrinology and Nutrition (SEEN), training courses and accreditation systems were established, and hospitals were encouraged to acquire ultrasound machines to expand their use in endocrinology practice.

The objective of the present study was to analyze the degree of implementation of cervical ultrasound and associated invasive techniques across Spain in 2025.

Section snippetsStudy design

We conducted a cross-sectional study from January through February 2025, based on the analysis and evaluation of responses to a self-administered survey sent by e-mail to endocrinology and nutrition departments operating within Spain.

Participant selection

Endocrinologists from both teaching and non-teaching hospitals across the Spanish autonomous communities who were members of SEEN were first selected. Subsequently, abstracts of presentations in lecture, poster, or oral communication formats presented at SEEN

Results

A total of 101 responses were received out of 107 centers contacted (94%), with no missing responses.

Discussion

In September 2014, 4 teaching hospitals (Clínico de Valladolid, Son Espases of Palma de Mallorca, Virgen de la Macarena of Seville, and Germans Trias i Pujol of Badalona) founded the Group of Imaging and Associated Techniques in Thyroid and Parathyroid Pathology within the SEEN, which, with the incorporation of new centers, has since developed significant efforts to promote the implementation of ultrasound and ultrasound-guided techniques in Spanish endocrinology and nutrition departments.

Conclusions

Over the past decade, thyroid ultrasound has been implemented in nearly all endocrinology and nutrition departments in Spain, improving efficiency and enabling the creation of high-resolution consultation units. However, a new phase begins in which percutaneous techniques must be expanded. To achieve this, it is crucial to promote training activities and integrate ultrasound procedures into the endocrinology residency curriculum.

Funding

None declared.

Declaration of competing interest

None declared.

References (24)J. Bodoque et al.Functional structure of a high resolution thyroid nodule unit. Economic impact and results of its implementation in an Endocrinology department

Endocrinol Diabetes Nutr (Engl Ed)

(2024)

G. Russ et al.Thyroid incidentalomas: epidemiology, risk stratification with ultrasound and workup

Eur Thyroid J

(2014)

View full text

© 2025 SEEN and SED. Published by Elsevier España, S.L.U. All rights are reserved, including those for text and data mining, AI training, and similar technologies.