1. American College of Endocrinology Report on Endocrine Certification in Neck Ultrasound (ECNU) H. Jack Baskin, MD, MACE

2. Endocrine Certification in Neck Ultrasound (ECNU) Two components:  Comprehensive Certification Exam (CCE)  Validation Process (VP) - Validation of competency in the performance and interpretation of diagnostic US and UG FNA

3. CCE  Computer-based  100 Multiple choice questions  Administered by Prometric TM  3 week window  Twice a year

4. CCE Content 1. Principles of ultrasound imaging 2. Neck anatomy 3. Thyroid pathology 4. Parathyroid pathology 5. Lymph node pathology 6. Ultrasound-guided FNA

5. Validation Process  Within 12 Months after passing CCE  Perform 100 (125) US studies 70% Ultrasound 30% UG FNA  Submit 15 examinations and reports

6. VP content 5 Cases nodular goiter 1 Case thyroiditis 2 Cases parathyroid pathology 2 Cases lymph node pathology 5 UG FNA

7. VP content –all reports Indication for performing procedure Measure thyroid and nodules in longitudinal x anterior-posterior x transverse plan (isthmus A-P) Diagnostic impression or differential diagnosis Disposition/plan

8. VP content - thyroid Description of thyroid parenchyma Description of significant nodules (echogenicity, margin, vascularity Describe in detail any abnormality (cyst, calcification, comet tails, etc) Description of neck lymph nodes

9. VP content – parathyroid adenoma Measurement of parathyroid Location of adenoma Echogenicity of parathyroid Description of vascularity with Doppler image Parathyroid must be verified by FNA (PTH in washout) or surgery

10. VP content – malignant lymph node Location of primary cancer Location of lymph node (compartment I thru VI) Measurement of short and long axis with Short/Long Axis Ratio (Transverse view) Echogenicity of lymph node Description of vascularity with Doppler image Presence or absence of hilar line, calcifications and cystic necrosis

11. Certification Results 3 years – 5 exams 330 Candidates took certifying examination 276 successfully passed exam 54 failed exam (20% fail rate) 136 have completed the VCP and are eligible to apply for AIUM practice accreditation

12. Recertification  Due 10 years after receiving ECNU  50 hours CME over 10 years  100 studies year before recertification  On line test of ultrasound images