Jenny Hoang


Dr. Jenny K. Hoang MBBS is a neuroradiologist and Associate Professor in Radiology and Radiation Oncology at Duke University, NC USA where she is the Director of Head and Neck Radiology and Chair of the Grand Rounds Committee. Her career is accentuated by her strong involvement in research and education. She led the American College of Radiology (ACR) efforts in producing a White Paper on Incidental Thyroid Findings and was a core member of the ACR TI-RADS committee for thyroid ultrasound. She also serves on the National Cancer Institute PDQ Screening and Prevention Editorial Board.

She has published more than 110 peer-reviewed articles with a focus on thyroid and parathyroid imaging. Dr. Hoang was the recipient of GE-Radiology Research Academic Fellowship (GERRAF) Program (2010-2012) and ACR Innovations Grant (2017). She is a popular a faculty lecturer at national and international meetings. She is also actively educating and advocating on Twitter. Connect with her at @JennyKHoang.


Associate Professor of Radiology

Radiology, Neuroradiology
School of Medicine

Member of the Duke Cancer Institute

Duke Cancer Institute
School of Medicine


M.B.B.S. 1999

University of Melbourne (Australia)


From ACR White Papers to National Guidelines: Formalizing the Consensus Process for Algorithm-Based Recommendations

Administered By
Radiology, Neuroradiology
Awarded By
American College of Radiology
Principal Investigator
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Incidental Thyroid Nodules Detected in the National Lung Screening Trial:

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ACR Appropriateness Criteria® Orbits Vision and Visual Loss.

Visual loss can be the result of an abnormality anywhere along the visual pathway including the globe, optic nerve, optic chiasm, optic tract, thalamus, optic radiations or primary visual cortex. Appropriate imaging analysis of visual loss is facilitated by a compartmental approach that establishes a differential diagnosis on the basis of suspected lesion location and specific clinical features. CT and MRI are the primary imaging modalities used to evaluate patients with visual loss and are often complementary in evaluating these patients. One modality may be preferred over the other depending on the specific clinical scenario. Depending on the pattern of visual loss and differential diagnosis, imaging coverage may require targeted evaluation of the orbits and/or assessment of the brain. Contrast is preferred when masses and inflammatory processes are differential considerations. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.
Expert Panel on Neurologic Imaging:,; Kennedy, TA; Corey, AS; Policeni, B; Agarwal, V; Burns, J; Harvey, HB; Hoang, J; Hunt, CH; Juliano, AF; Mack, W; Moonis, G; Murad, GJA; Pannell, JS; Parsons, MS; Powers, WJ; Schroeder, JW; Setzen, G; Whitehead, MT; Bykowski, J
MLA Citation
Expert Panel on Neurologic Imaging:, Julie, et al. “ACR Appropriateness Criteria® Orbits Vision and Visual Loss..” J Am Coll Radiol, vol. 15, no. 5S, May 2018, pp. S116–31. Pubmed, doi:10.1016/j.jacr.2018.03.023.
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Journal of the American College of Radiology : Jacr
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Applying Criteria of Active Surveillance to Low-Risk Papillary Thyroid Cancer Over a Decade: How Many Surgeries and Complications Can Be Avoided?

BACKGROUND: The 2015 American Thyroid Association guidelines acknowledged that "an active surveillance management approach can be considered as an alternative to immediate surgery" in patients with low-risk papillary thyroid carcinoma (PTC). The aim of this study was to determine the proportion of PTC that would meet the criteria for active surveillance and the surgeries and complications that could have been avoided. METHODS: A total of 681 patients with thyroid cancer who underwent thyroid surgery from 2003 to 2012 were retrospectively reviewed. A decision-making framework for active surveillance was applied to patients with PTC in nodules measuring ≤1.5 cm on ultrasound. Patients were identified as suitable for active surveillance based on imaging and patient characteristics. These patients were reviewed for management and outcomes. RESULTS: PTC was diagnosed based on fine-needle aspiration histology of Bethesda V or VI in thyroid nodules in 243 patients. Of these, 77 patients had nodules measuring ≤1.5 cm on ultrasound, and 56/77 (23%) patients met the criteria for surveillance: 15/243 (6%) patients met the criteria with a ≤1 cm size threshold, and 41/243 (17%) met the criteria with a 1.1-1.5 cm threshold. Of the 56 patients who met the criteria for active surveillance, 52 underwent total thyroidectomy, and four had a lobectomy. Forty-five (80%) patients had elective central nodal dissection, and 14 had nodal metastases on pathology (all <4 mm). Three patients had permanent complications from surgery, including vocal cord paralysis, hypoparathyroidism, and a chipped tooth from intubation. No patients died or had recurrent disease. CONCLUSION: Future programs in the United States should consider increasing the size threshold for active surveillance of PTC to 1.5 cm, since this will allow up to one quarter of patients to be eligible instead of only 6% with a 1 cm size threshold. Without an active surveillance program, the majority of patients with low-risk cancers have thyroidectomy and carry a small risk of permanent complications.
Griffin, A; Brito, JP; Bahl, M; Hoang, JK
MLA Citation
Griffin, Andrew, et al. “Applying Criteria of Active Surveillance to Low-Risk Papillary Thyroid Cancer Over a Decade: How Many Surgeries and Complications Can Be Avoided?.” Thyroid, vol. 27, no. 4, Apr. 2017, pp. 518–23. Pubmed, doi:10.1089/thy.2016.0568.
Published In
Thyroid : Official Journal of the American Thyroid Association
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Rare cases of large parapharyngeal lipomas.

Primary tumors of the parapharyngeal space are extremely rare, and lipomas are among the least common primary parapharyngeal space masses. Parapharyngeal lipomas typically present as a painless neck mass, and some may present with neurologic deficits or vascular compromise attributed to the lipomas' mass effect on nearby neurovascular structures. We report long term follow-up of two large parapharyngeal lipomas. One lesion was managed expectantly, and the other was managed with a partial transcervical excision. We demonstrate that conservative management and long term patient follow-up may be reasonable if the patient is asymptomatic and liposarcoma is ruled out. Considering the uncertainty in the need for removal, the management strategy for the individual patient is best to be tailored to their clinical presentation.
Crowson, MG; Hoang, J; Esclamado, RM
MLA Citation
Crowson, Matthew G., et al. “Rare cases of large parapharyngeal lipomas..” Am J Otolaryngol, vol. 37, no. 1, Jan. 2016, pp. 54–58. Pubmed, doi:10.1016/j.amjoto.2015.09.011.
Published In
Am J Otolaryngol
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A novel method of estimating effective dose from the point dose method: a case study--parathyroid CT scans.

The purpose of this study was to validate a novel approach of applying a partial volume correction factor (PVCF) using a limited number of MOSFET detectors in the effective dose (E) calculation. The results of the proposed PVCF method were compared to the results from both the point dose (PD) method and a commercial CT dose estimation software (CT-Expo). To measure organ doses, an adult female anthropomorphic phantom was loaded with 20 MOSFET detectors and was scanned using the non-contrast and 2 phase contrast-enhanced parathyroid imaging protocols on a 64-slice multi-detector computed tomography scanner. E was computed by three methods: the PD method, the PVCF method, and the CT-Expo method. The E (in mSv) for the PD method, the PVCF method, and CT-Expo method was 2.6  ±  0.2, 1.3  ±  0.1, and 1.1 for the non-contrast scan, 21.9  ±  0.4, 13.9  ±  0.2, and 14.6 for the 1st phase of the contrast-enhanced scan, and 15.5  ±  0.3, 9.8  ±  0.1, and 10.4 for the 2nd phase of the contrast-enhanced scan, respectively. The E with the PD method differed from the PVCF method by 66.7% for the non-contrast scan, by 44.9% and by 45.5% respectively for the 1st and 2nd phases of the contrast-enhanced scan. The E with PVCF was comparable to the results from the CT-Expo method with percent differences of 15.8%, 5.0%, and 6.3% for the non-contrast scan and the 1st and 2nd phases of the contrast-enhanced scan, respectively. To conclude, the PVCF method estimated E within 16% difference as compared to 50-70% in the PD method. In addition, the results demonstrate that E can be estimated accurately from a limited number of detectors.
Januzis, N; Nguyen, G; Hoang, JK; Lowry, C; Yoshizumi, TT
MLA Citation
Januzis, Natalie, et al. “A novel method of estimating effective dose from the point dose method: a case study--parathyroid CT scans..” Phys Med Biol, vol. 60, no. 5, Mar. 2015, pp. 1763–73. Pubmed, doi:10.1088/0031-9155/60/5/1763.
Published In
Phys Med Biol
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High variability in radiologists' reporting practices for incidental thyroid nodules detected on CT and MRI.

BACKGROUND AND PURPOSE: There are no guidelines for reporting incidental thyroid nodules seen on CT and MR imaging. We evaluated radiologists' current reporting practices for incidental thyroid nodules detected on these imaging modalities. MATERIALS AND METHODS: Radiologists were surveyed regarding their reporting practices by using 14 scenarios of incidental thyroid nodules differing in size, patient demographics, and clinical history. Scenarios were evaluated for the following: 1) radiologists' most commonly selected response, and 2) the proportion of radiologists selecting that response (degree of agreement). These measures were used to determine how the patient scenario and characteristics of the radiologists affected variability in practice. RESULTS: One hundred fifty-three radiologists participated. In 8/14 scenarios, the most common response was to "recommend sonography." For the other scenarios, the most common response was to "report in only body of report." The overall mean agreement for the 14 scenarios was 53%, and agreement ranged from 36% to 75%. Smaller nodules had lower agreement: 43%-51% for 8-mm nodules compared with 64%-75% for 15-mm nodules. Agreement was poorest for the 10-mm nodule in a 60-year-old woman (36%) and for scenarios with additional history of lung cancer (39%) and multiple nodules (36%). There was no significant difference in reporting practices and agreement when radiologists were categorized by years of practice, practice type, and subspecialty (P > .55). CONCLUSIONS: The reporting practice for incidental thyroid nodules on CT or MR imaging is highly variable among radiologists, especially for patients with smaller nodules (≤10 mm) and patients with multiple nodules and a history of cancer. This variability highlights the need for practice guidelines.
Hoang, JK; Riofrio, A; Bashir, MR; Kranz, PG; Eastwood, JD
MLA Citation
Hoang, J. K., et al. “High variability in radiologists' reporting practices for incidental thyroid nodules detected on CT and MRI.Ajnr Am J Neuroradiol, vol. 35, no. 6, June 2014, pp. 1190–94. Pubmed, doi:10.3174/ajnr.A3834.
Published In
Ajnr Am J Neuroradiol
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Research Areas:

Academic Medical Centers
Age Distribution
Anesthetics, Local
Angiogenesis Inhibitors
Anti-Inflammatory Agents
Aorta, Thoracic
Biopsy, Fine-Needle
Body Burden
Brain Ischemia
Brain Neoplasms
Carcinoma, Intraductal, Noninfiltrating
Carcinoma, Papillary
Carcinoma, Renal Cell
Carcinoma, Squamous Cell
Carotid Artery, Internal
Case-Control Studies
Cervical Vertebrae
Circle of Willis
Coronary Angiography
Coronary Disease
Dose-Response Relationship, Drug
Fibromuscular Dysplasia
Fluorodeoxyglucose F18
Four-Dimensional Computed Tomography
Frontal Bone
Guideline Adherence
Head and Neck Neoplasms
Health Care Surveys
Hyperparathyroidism, Primary
Image Enhancement
Imaging, Three-Dimensional
Incidental Findings
Injections, Epidural
Injections, Intra-Arterial
Injections, Intralesional
Injections, Intravenous
Jugular Veins
Kidney Neoplasms
Lymph Nodes
Lymphatic Metastasis
Magnetic Resonance Angiography
Nasopharyngeal Neoplasms
Nerve Block
Observer Variation
Organ Size
Outcome Assessment (Health Care)
Parathyroid Neoplasms
Parotid Gland
Patient Safety
Petrous Bone
Phantoms, Imaging
Physician's Practice Patterns
Positron-Emission Tomography
Practice Guidelines as Topic
Practice Patterns, Physicians'
Pulmonary Artery
Radiation Dosage
Radiation Protection
Radiographic Image Enhancement
Radiographic Image Interpretation, Computer-Assisted
Radiotherapy, Conformal
Respiratory-Gated Imaging Techniques
Retropharyngeal Abscess
Sex Distribution
Sex Factors
Spinal Nerve Roots
Staphylococcal Infections
Statistics, Nonparametric
Streptococcal Infections
Thyroid Diseases
Thyroid Gland
Thyroid Neoplasms
Thyroid Nodule
Tomography, Spiral Computed
Tomography, X-Ray Computed
Treatment Outcome
Triiodobenzoic Acids
Tumor Burden
Young Adult