PAPILLON COURSE on THYROID ULTRASOUND

Here we present our proposal for participants of the course. First, I give a suggested schedule, then I summarize my proposal.

Prerequisite

The course is announced for colleagues who are either experienced ultrasonographer or have completed the Basic Papillon Course. Nevertheless, we summarize some important introductory topics.

L0 The normal thyroid - how to find the thyroid gland and how it looks like in a healthy individual (3 hs)

prerecorded presentation

L0 Epidemiology of thyroid (E.V.Nagy)

prerecorded presentation

L0 Technical details and background physics of ultrasound examination (E.Csajbok)

prerecorded presentation

L2 The role of thyroid ultrasound in the evaluation of thyroid patients (1 hr)

prerecorded presentation, manual

 December 1 - Type 1 Webinar (1.5 hours)

L1 Course arrangement and teaching goals (1 hr)

We give an overview of the course.

Discuss some important technical conditions.

 

 

December 1 to December 15 - individual learning

Topics and related learning material

L3 Composition of a thyroid nodule; cystic and solid nodules (6 hs)

prerecorded presentation, manual, differential diagnostic tables, 15 voice over video case studies

L4 Echogenicity of the nodule (10 hs)

prerecorded presentation, manual, differential diagnostic tables, 35 voice over video case studies, EXAM

December 15 - Type 1 Webinar (1.5 hours)

Presentation of the short version of L3 and L4.

Common analysis of related ultrasound voice over video case studies.

Reviewing the voice over video case studies in advance requires 1 hr additional effort.

 

December 16 to January 5 - individual learning

Topic and related learning material

L5 Intranodular hyperechogenic figures (10 hs)

prerecorded presentation, manual, differential diagnostic tables, 30 voice over video case studies and EXAM

January 5 - Type 1 Webinar (1.5 hours)

Presentation of the short version of L5.

Common analysis of related ultrasound voice over video case studies.

Reviewing the voice over video case studies in advance requires 1 hr additional effort.

 

January 6 to January 19 - individual learning

Topics and related learning material

L6 The borders of the nodule (6 hs)

prerecorded presentation, manual, differential diagnostic tables, 15 voice over video case studies, EXAM

L7 The shape of the nodule (4 hs)

prerecorded presentation, manual, differential diagnostic tables, 15 voice over video case studies

January 19 - Type 1 Webinar (1.5 hours)

Presentation of the short version of L6 and L7.

Common analysis of related ultrasound voice over video case studies.

Reviewing the voice over video case studies in advance requires 1 hr additional effort.

 

January 20 to February 2 - individual learning

Topics and related learning material

L8 Extrathyroidal spread (3 hs)

prerecorded presentation, manual, differential diagnostic tables, 15 voice over video case studies

L9 The halo sign and the vascularization of the nodule (3 hs)

prerecorded presentation, manual, differential diagnostic tables, 20 voice over video case studies

February 2 - Type 1 Webinar (1.5 hours)

Presentation of the short version of L8 and L9.

Common analysis of related ultrasound voice over video case studies.

Reviewing the voice over video case studies in advance requires 1 hr additional effort.

 

February 3 to February 16 - individual learning

Topics and related learning material

L 10 The TIRADS (10 hs)

manual, differential diagnostic tables, 60 voice over video case studies, EXAM

L 11 Elastography (2hs)

15 voice over video case studies

 February 16 - Type 2 Webinar (1.5 hours)

L10 The European TIRADS (G.Russ)

30-min lecture followed by 15-min discussion

L10 TIRADS - Benefits and concerns (C.Durante)

30-min lecture followed by 15-min discussion

 

February 17 to March 2 - individual learning

Topics and related learning material

L12 Lymphocytic thyroiditis (8 hs)

prerecorded presentation, manual, differential diagnostic tables, 20 voice over video case studies

L13 Graves' disease (4 hs)

prerecorded presentation, manual, differential diagnostic tables, 15 voice over video case studies

L14 Subacute granulomatous thyroiditis (6 hs)

prerecorded presentation, manual, differential diagnostic tables, 15 voice over video case studies

March 2 - Type 1 Webinar (1.5 hours)

Presentation of the short version of L12, L13 and L14.

Common analysis of related ultrasound voice over video case studies.

Reviewing the voice over video case studies in advance requires 1 hr additional effort.

 

March 3 to March 16 - individual learning

Topic and related learning material

L15 Parathyroid (3 hs)

manual, differential diagnostic tables, 15 voice over video case studies

L16 Lymph nodes in the neck (6 hs)

manual, differential diagnostic tables, 25 voice over video case studies

L18 Other structures in the neck (2 hs)

24 voice over video case studies

March 9 - Type 2 Webinar (1.5 hours)

L15 The parathyroid (A.Frasoldati)

30-min lecture followed by 15-min discussion

L16 Lymph nodes in the neck (K.Molnar)

30-min lecture followed by 15-min discussion

March 16 - Type 2 Webinar (1.5 hours)

L17 The neck compartments and their importance (L.Leenhardt)

30-min lecture followed by 15-min discussion

L18 Other structures in the neck (R.Ngu)

30-min lecture followed by 15-min discussion

March 17 to March 23 - individual learning

Topics and related learning material

L19 Ultrasound guided aspiration (3 hs)

Prerecorded presentation

L19 Percutaneous ethanol sclerotherapy (3 hs)

Manual, 15 voice over video case studies

 

March 23 - Type 2 Webinar (1.5 hours)

L20 The role of non-surgical techniques in the treatment of nodular goiter (S.Bonnema)

30-min lecture followed by 15-min discussion

L21 Thermal ablation techniques for thyroid lesions (E.Papini)

30-min lecture followed by 15-min discussion

 

March 24 to March 30 - individual learning

Topics and related learning material

L22 Ectopic thyroid disease (3 hs)

differential diagnostic tables, 10 voice over video case studies

L23 Difficult-to-examine patients and substernal spread (3 hs)

differential diagnostic tables, 15 voice over video case studies

L24 The operated thyroid (6 hs)

prerecorded presentation, differential diagnostic tables, 25 voice over video case studies

March 30 - Type 1 Webinar (1.5 hours)

Presentation of the short version of L24.

Common analysis of ultrasound voice over video case studies related to L22, L23 and L24.

Reviewing the voice over video case studies in advance requires 1 hr additional effort.

 

March 31 to April 13 - individual learning

Topics and related learning material

L25 The relation between discrete lesions and pathological nodule (16 hs)

prerecorded presentation, differential diagnostic tables, 40 voice over video case studies

L26 Teamwork (6 hs)

prerecorded presentation, manual, differential diagnostic tables, 20 voice over video case studies

April 13 - Type 1 Webinar (1.5 hours)

Presentation of the short version of L25.

Common analysis of ultrasound voice over video case studies related to L25, L26 and L27.

Reviewing the voice over video case studies in advance requires 1 hr additional effort.

 

 April 13 to April 20 - Type 2 Webinar (1.5 hours)

L27 Ultrasound presentation of thyroid cancers (6 hs)

prerecorded presentation, manual, differential diagnostic tables, 20 voice over video case studies

April 20 - Type 2 Webinar (1.5 hours)

L28 Ultrasound follow-up of patient operated on thyroid cancer (M.F.Erdogan)

30-min lecture followed by 15-min discussion

L28 Discussion of related ultrasound videos

45-min discussion

April 27 - Type 2 Webinar (1.5 hours)

L29 Alternative imaging techniques (CT, MR, PET-CT, nuclear) (E.Mezosi)

30-min lecture followed by 15-min discussion

L30 The aspect of the surgeon (F.Menegaux)

30-min lecture followed by 15-min discussion

 

May 4 - Type 2 Webinar (2 hours)

L31 Lecture on fine-needle aspiration cytology (F.Schmidt)

30-min lecture followed by 15-min discussion

L32 The Bethesda system (P.Vielh)

30-min lecture followed by 15-min discussion

L33 The technique of core biopsy (G.Russh)

10-min lecture followed by 5-min discussion

May 11 - Type 2 Webinar (1.5 hours)

L34 When and how should molecular diagnostics be integrated in the malignancy risk stratification of thyroid nodules? (R.Paschke)

30-min lecture followed by 15-min discussion

L35 Thyroid pathology (E.Toth)

30-min lecture followed by 15-min discussion

May 25 - Type 2 Webinar (1.5 hours)

Topics and related learning material

L37 A personal half century tour down US memory lane. From ignorance to implementation and abuse? (L.Hegedűs)

30-min lecture followed by 15-min discussion

L38 The importance of first impression (T.Solymosi)

Common discussion of cases

Reviewing related cases requires 1 hr additional effort.

 

How to manage the learning material?

Completion of the course requires a significant time investment from the learner. On average, this means at least six hours of work per week during the 25 weeks of the course.

I think it is worthwhile to proceed with the curriculum as described above. After studying the prerecorded lecture and manual for each chapter, it is worth reviewing the differential diagnosis tables. The 3-8 cases highlighted in red in the CASES item belonging to each chapter are definitely worth a look.

As you can see from the table below, after the first 19 weeks of the course, there are six calmer weeks. It is worth using these six weeks and the additional 4 weeks available until the exams are completed by June 30 (i.e. 10 weeks in total) to review the material again.

The materials subject to registration will remain available until August 31, 2023, and the more than 1,000 case studies with the associated voice-over ultrasound video will remain freely available even after that.

Date	Discussed topics	Time required (hs)
From Dec. 1 to Dec. 15	Role of ultrasound Compostition of nodule Echogenicity of nodule	20 hours/2 weeks
From Dec. 16 to Jan. 5	Intranodular echogenic figures	13 hours/3 weeks
From Jan. 6 to Jan. 19	The borders of the nodule The shape of the nodule	13 hours/2 weeks
From Jan. 20 to Febr. 2	Extrathyroidal spread The halo sign and the vascularization of the nodule	9 hours/2 weeks
From Febr. 3 to Febr. 16	TIRADS Elastography	14 hours/2 weeks
From Febr. 17 to March 2	Lymphocytic thyroiditis Graves' disease Subacute granulomatous thyroiditis	21 hours/2 weeks
From March 3 to March 16	Parathyroid Lymph nodes in the neck Other neck structures	11 hours/2 weeks
From March 17 to March 23	Ultrasound guided aspiration Non-surgical techniques	8 hours/1 week
From March 24 to April 13	Ectopic thyroid Large goiters Operated thyroid	14 hours/1 week
From April 13 to April 20	Discrete lesions vs. pathological nodule Teamwork	25 hours/2 weeks
From April 21 to May 31	Type 2 webinars discussing related topics	7.5 hours/6 weeks

Some practical advice

• It is very important that you follow the instructions described in the MUST READ and in TECHNICAL HELP items.

• It's okay if you didn't have enough time to review one of the chapters. Get on with the material. In the last 10 weeks of the course and the following 2 months, you will be able to fill in the gaps.

• In the first month of the course, go through the 20 case studies of one of the exams to see how it works and how much time you will have to spend on it.

• You start taking an exam when you have an undisturbed hour.

• It's not a big deal if you can't attend a webinar. But as soon as you have time, watch the recording of the webinar. All webinars will take place on Thursday, the edited version will be presented in the website within 4 days.