Preface for English-speaking audience


As a result of the accident at the Chernobyl Nuclear Power Station in 1986, millions of Curie of radioactive substances - among which iodine radionuclides were predominant - have been released and spread through out huge territories. Already in the first days of the accident, there was no doubt that the catastrophe would lead - in the long term - to an increase in thyroid tumor incidence. 

And, actually, radiation has proved to be a determinant factor of thyroid malignant tumor development, particularly among children. An increase in thyroid cancer incidence in children of Ukraine was reported for the first time four years after the Chernobyl catastrophe. If for five years before the Chernobyl accident only 25 cases of children and 14 cases of adolescents operated on for thyroid carcinomas had been included in medical records in Ukraine, for 18 years elapsed after the accident about 3,000 patients aged 0 to 18 years at the time of the accident, have already been operated on. A marked increase in thyroid cancer incidence among children of Ukraine and Belarus (this tendency remaining till now) has confirmed, unfortunately, all the severity of the after-effects of the accident for the affected population. 

The Department of Ultrasound Diagnosis and Aspiration Biopsy of our Institute was established in 1986, shortly after the accident, with the purpose of scientific development and application of the method of ultrasound thyroid examination, which had not been used before, to daily clinical practice in Ukraine, allowing to follow up the population affected as a result of the Chernobyl accident.

Already by the end of 1986, we have introduced the method of ultrasound examination of the thyroid in clinical practice throughout Ukraine. In 1987, a technique of fine-needle aspiration biopsy (FNA) of thyroid nodules has been developed - and for the first time performed - in our Department. Beginning from 1988, the Department became a main scientific-methodical basis for training physicians of Ukraine in the methods of thyroid USI and FNA biopsy. Thus, as says a Russian proverb, “Every cloud has a silver lining”:  the Chernobyl accident of 1986 gave a powerful incentive to the development of state-of-the-art methods of diagnosis and treatment of thyroid diseases in Ukraine.

Today, annually, more than 35,000 ultrasound examinations of the thyroid and 4,000 FNA biopsy of thyroid nodules are conducted in our Department, and more than 2,000 operations on the thyroid performed in the Institute’s Department of Surgery. The electronic Registry of our Institute includes more than 200,000 patients. I may affirm that few institutions in the world may have such experience in the diagnosis and management of thyroid disorders. 

In 2004, we have published a basic monograph entitled “Ultrasound Examination of the Thyroid Gland. Atlas and Guidelines” (E.V. Epshtein, S.I. Matiashchuk, 382 p.), which has been granted an award in 2006 as the best edition of Ukraine in the field of medicine. Till now, this edition remains a reference book for ultrasonographers, and not only from Ukraine. An electronic version of 2004 is available on-line in Russian; at present, a new largely supplemented multimedia edition is planned for publication in English. 

At the same time, unfortunately, for different reasons, till present not a publication is available in English. Such an opportunity has presented itself only now, in particular, owing to creation, development, and support of our website. 

We would like to offer for your consideration our first material in English, with a brief outline of the main results of own long-term scientific researches and experience of their application to daily clinical practice - concerning diagnosis, differential diagnosis and clinical tactics in different types of thyroid neoplasms. In the format of a film (47 min), all the main ultrasound models of benign and malignant thyroid nodules are shown, including morphological structure, FNA results, as well as indications for aspiration biopsy and surgical treatment for each of the models, in accordance with modern international Clinical Protocols for nodular thyroid pathology.

  • See Film (see on-line and/or free download; 48 min, flv, 343 Mb)
  • See Clinical Atlas (pdf, 636 p, 575 pic), additionally contains: 

    • a chapter entitled «Individual ultrasound signs of thyroid tumors» that contains seven sections which give a detailed description of the basic ultrasound features of thyroid nodules: shape, border, echogenicity, cystic cavities, hyperechoic inclusions, vascular structures, and enlargement of regional lymph nodes;
    • an extended Appendix with а lot of clinical examples of pathomorphologically verified sonograms and FNA biopsy results of different types of thyroid nodules.


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