最近小甲状腺乳头状癌（PTC）发病率的激增与超声检查的广泛使用有关，从而引发了人们对过度诊断的担忧。主动监测 (AS) 已成为低风险 PTC 的一种侵入性较小的替代管理策略，特别是对于最大直径≤1 cm 的 PTC。最近的研究报告称，AS 下 ≤1 cm 的低风险 PTC 的疾病进展率较低。目前正在进行的研究正在探索 AS 用于较大 PTC（<20 mm）的可行性。 AS 协议包括细致的超声评估、强调标准化技术和多学科方法；它们涉及监测结节的大小、生长、潜在的甲状腺外延伸、靠近气管和喉返神经以及潜在的颈部淋巴结转移。进展标准通常定义为 PTC 最大直径的增加，需要对精确度和正在进行的检查进行审查。用于定义 PTC 疾病进展的体积测量的可靠性存在挑战。尽管超声检查发挥着关键作用，但评估进展和轻微甲状腺外扩展的挑战强调了多学科方法在疾病管理中的重要性。这份全面的概述强调了 PTC 的 AS 不断发展的前景，强调了标准化方案、细致评估和持续研究为决策提供信息的必要性。版权所有 © 2024 韩国放射学会。

The recent surge in the incidence of small papillary thyroid cancers (PTCs) has been linked to the widespread use of ultrasonography, thereby prompting concerns regarding overdiagnosis. Active surveillance (AS) has emerged as a less invasive alternative management strategy for low-risk PTCs, especially for PTCs measuring ≤1 cm in maximal diameter. Recent studies report low disease progression rates of low-risk PTCs ≤1 cm under AS. Ongoing research is currently exploring the feasibility of AS for larger PTCs (<20 mm). AS protocols include meticulous ultrasound assessment, emphasis on standardized techniques, and a multidisciplinary approach; they involve monitoring the nodules for size, growth, potential extrathyroidal extension, proximity to the trachea and recurrent laryngeal nerve, and potential cervical nodal metastases. The criteria for progression, often defined as an increase in the maximum diameter of the PTC, warrant a review of precision and ongoing examinations. Challenges exist regarding the reliability of volume measurements for defining PTC disease progression. Although ultrasonography plays a pivotal role, challenges in assessing progression and minor extrathyroidal extension underscore the importance of a multidisciplinary approach in disease management. This comprehensive overview highlights the evolving landscape of AS for PTCs, emphasizing the need for standardized protocols, meticulous assessments, and ongoing research to inform decision-making.Copyright © 2024 The Korean Society of Radiology.