How should thyroid nodules be evaluated?

Thyroid nodule evaluation begins with TSH measurement and ultrasound. Fine-needle aspiration is indicated based on nodule size and ultrasound features (TI-RADS classification). Highly suspicious nodules ≥1cm require FNA. Low-risk nodules can be monitored with serial ultrasound. Molecular testing aids decision-making for indeterminate cytology. Suppressive therapy is no longer recommended for benign nodules.