Endocrine Neck/Thyroid Imaging Conclusions
1.No absolute clinical indication for any imaging procedures.
2. None can tell benign nodules from cancer, except possible spongioform type of thyroid nodule that appears to almost 100% benign.
3. Ultrasound give more detail imaging compared to I/123 scanning, and is essential at needle placement for biopsies.
4. Ultrasound is a valuable aid in placing the probe for radiofrequency ablation procedures RFA.
5. Ultrasound is a valuable aid for placement of the needle for cyst or cancer lymph node biopsy, cyst fluid evacuation and the final treatment injection of ethanol into the cyst cavity or cancer lymph node. PEI.
6. Give more accurate nodule volumes than palpation.
7. CT and MR gives similar information as US but is expensive.
8. CT/MR are better at imaging lymph nodes in places not reached by neck US.
9. Major advances include fusion techniques on integrated CT/PET images which combine structure (CT) with functional ( increased activity) PET.
Images of a USG RFA treated patient’s neck before and after RFA.