Abstract
Ultrasonography (US) is a critical imaging modality for visualizing structures in the neck. A safe and inexpensive test, US can be easily performed in the outpatient setting by clinicians with specialty training and experience. This chapter will outline the initial approach to a patient suspected of having a thyroid nodule including laboratory testing and indications for ultrasonography and thyroid scintigraphy. The advantages of an office-based US exam over that performed by radiology will be outlined. Finally, the sonographic features of nodules and lymph nodes and their attendant malignancy risk will be outlined.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Mazzaferri EL. Management of a solitary thyroid nodule. N Engl J Med. 1993;328(8):553–9.
Yang J, et al. Fine-needle aspiration of thyroid nodules: a study of 4703 patients with histologic and clinical correlations. Cancer. 2007;111(5):306–15.
Yassa L, et al. Long-term assessment of a multidisciplinary approach to thyroid nodule diagnostic evaluation. Cancer. 2007;111(6):508–16.
Kwong N, et al. The Influence of patient age on thyroid nodule formation, multinodularity, and thyroid cancer risk. J Clin Endocrinol Metab. 2015;100(12):4434–40.
Brander A, et al. Clinical versus ultrasound examination of the thyroid gland in common clinical practice. J Clin Ultrasound. 1992;20(1):37–42.
Marqusee E, et al. Usefulness of ultrasonography in the management of nodular thyroid disease. Ann Intern Med. 2000;133(9):696–700.
Haugen BR, et al. 2015 American Thyroid Association Management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: The American Thyroid association guidelines task force on thyroid nodules and differentiated thyroid cancer. Thyroid. 2016;26(1):1–133.
Van Nostrand D, et al. (124)I positron emission tomography versus (131)I planar imaging in the identification of residual thyroid tissue and/or metastasis in patients who have well-differentiated thyroid cancer. Thyroid. 2010;20(8):879–83.
Wong KT, et al. Current role of radionuclide imaging in differentiated thyroid cancer. Cancer Imaging. 2008;8:159–62.
Bahn RS, Castro MR. Approach to the patient with nontoxic multinodular goiter. J Clin Endocrinol Metab. 2011;96(5):1202–12.
Cooper DS, American Thyroid Association Guidelines Taskforce on Thyroid, N, et al. Revised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid. 2009;19(11):1167–214.
Alexander EK, et al. Preoperative diagnosis of benign thyroid nodules with indeterminate cytology. N Engl J Med. 2012;367(8):705–15.
Reschini E, et al. The trapping-only nodules of the thyroid gland: prevalence study. Thyroid. 2006;16(8):757–62.
Arnold JE, Pinsky S. Comparison of 99mTc and 123I for thyroid imaging. J Nucl Med. 1976;17(4):261–7.
Shambaugh 3rd GE, et al. Disparate thyroid imaging. Combined studies with sodium pertechnetate Tc 99m and radioactive iodine. JAMA. 1974;228(7):866–9.
Hamer PW, Aspinall SR, Malycha PL. Clinician-performed ultrasound in assessing potentially malignant thyroid nodules. ANZ J Surg. 2014;84(5):376–9.
Mazzaferri EL, Jhiang SM. Long-term impact of initial surgical and medical therapy on papillary and follicular thyroid cancer. Am J Med. 1994;97(5):418–28.
Grant CS, et al. Risks and adequacy of an optimized surgical approach to the primary surgical management of papillary thyroid carcinoma treated during 1999–2006. World J Surg. 2010;34(6):1239–46.
Bardet S, et al. Macroscopic lymph-node involvement and neck dissection predict lymph-node recurrence in papillary thyroid carcinoma. Eur J Endocrinol. 2008;158(4):551–60.
Urken ML, et al. Management of recurrent and persistent metastatic lymph nodes in well-differentiated thyroid cancer: a multifactorial decision-making guide for the thyroid cancer care collaborative. Head Neck. 2015;37(4):605–14.
Carneiro-Pla D, Amin S. Comparison between preconsultation ultrasonography and office surgeon-performed ultrasound in patients with thyroid cancer. World J Surg. 2014;38(3):622–7.
Sharen G, et al. Retrospective epidemiological study of thyroid nodules by ultrasound in asymptomatic subjects. Chin Med J (Engl). 2014;127(9):1661–5.
Sipos JA. Advances in ultrasound for the diagnosis and management of thyroid cancer. Thyroid. 2009;19(12):1363–72.
Davies L, Welch HG. Increasing incidence of thyroid cancer in the United States, 1973–2002. JAMA. 2006;295(18):2164–7.
Frates MC, et al. Prevalence and distribution of carcinoma in patients with solitary and multiple thyroid nodules on sonography. J Clin Endocrinol Metab. 2006;91(9):3411–7.
Moon WJ, et al. Benign and malignant thyroid nodules: US differentiation–multicenter retrospective study. Radiology. 2008;247(3):762–70.
Moon HJ, et al. Diagnostic performance of gray-scale US and elastography in solid thyroid nodules. Radiology. 2012;262(3):1002–13.
Kwak JY, et al. Thyroid imaging reporting and data system for US features of nodules: a step in establishing better stratification of cancer risk. Radiology. 2011;260(3):892–9.
Papini E, et al. Risk of malignancy in nonpalpable thyroid nodules: predictive value of ultrasound and color-Doppler features. J Clin Endocrinol Metab. 2002;87(5):1941–6.
Kim DS, et al. Sonographic features of follicular variant papillary thyroid carcinomas in comparison with conventional papillary thyroid carcinomas. J Ultrasound Med. 2009;28(12):1685–92.
Park YJ, et al. Thyroid nodules with macrocalcification: sonographic findings predictive of malignancy. Yonsei Med J. 2014;55(2):339–44.
Cappelli C, et al. The predictive value of ultrasound findings in the management of thyroid nodules. QJM. 2007;100(1):29–35.
Cerbone G, et al. Power Doppler improves the diagnostic accuracy of color Doppler ultrasonography in cold thyroid nodules: follow-up results. Horm Res. 1999;52(1):19–24.
Moon HJ, et al. Can vascularity at power Doppler US help predict thyroid malignancy? Radiology. 2010;255(1):260–9.
Malhi H, et al. Echogenic foci in thyroid nodules: significance of posterior acoustic artifacts. AJR Am J Roentgenol. 2014;203(6):1310–6.
Russ G, et al. Prospective evaluation of thyroid imaging reporting and data system on 4550 nodules with and without elastography. Eur J Endocrinol. 2013;168(5):649–55.
Cheng SP, et al. Characterization of thyroid nodules using the proposed thyroid imaging reporting and data system (TI-RADS). Head Neck. 2013;35(4):541–7.
Park JY, et al. A proposal for a thyroid imaging reporting and data system for ultrasound features of thyroid carcinoma. Thyroid. 2009;19(11):1257–64.
Hamming JF, et al. The value of fine-needle aspiration biopsy in patients with nodular thyroid disease divided into groups of suspicion of malignant neoplasms on clinical grounds. Arch Intern Med. 1990;150(1):113–6.
Park JS, et al. Performance of preoperative sonographic staging of papillary thyroid carcinoma based on the sixth edition of the AJCC/UICC TNM classification system. AJR Am J Roentgenol. 2009;192(1):66–72.
Ahn JE, et al. Diagnostic accuracy of CT and ultrasonography for evaluating metastatic cervical lymph nodes in patients with thyroid cancer. World J Surg. 2008;32(7):1552–8.
Kuna SK, et al. Ultrasonographic differentiation of benign from malignant neck lymphadenopathy in thyroid cancer. J Ultrasound Med. 2006;25(12):1531–7; quiz 1538–40.
Solbiati L, et al. Ultrasound of thyroid, parathyroid glands and neck lymph nodes. Eur Radiol. 2001;11(12):2411–24.
Ahuja AT, et al. Power Doppler sonography of metastatic nodes from papillary carcinoma of the thyroid. Clin Radiol. 2001;56(4):284–8.
Leboulleux S, et al. Ultrasound criteria of malignancy for cervical lymph nodes in patients followed up for differentiated thyroid cancer. J Clin Endocrinol Metab. 2007;92(9):3590–4.
Ying M, Ahuja A. Sonography of neck lymph nodes. Part I: normal lymph nodes. Clin Radiol. 2003;58(5):351–8.
Ahuja A, Ying M. Sonography of neck lymph nodes. Part II: abnormal lymph nodes. Clin Radiol. 2003;58(5):359–66.
Wunderbaldinger P, et al. Cystic lymph node metastases in papillary thyroid carcinoma. AJR Am J Roentgenol. 2002;178(3):693–7.
Gorman B, et al. Medullary thyroid carcinoma: role of high-resolution US. Radiology. 1987;162(1 Pt 1):147–50.
Hong HS, et al. Ultrasonography of various thyroid diseases in children and adolescents: a pictorial essay. Korean J Radiol. 2015;16(2):419–29.
Sakai F, et al. Ultrasonography of thymoma with pathologic correlation. Acta Radiol. 1994;35(1):25–9.
Kwak JY, Kim EK. Sonographic findings of Zenker diverticula. J Ultrasound Med. 2006;25(5):639–42.
Kobaly K, Mandel SJ, Langer JE. Clinical review: Thyroid cancer mimics on surveillance neck sonography. J Clin Endocrinol Metab. 2015;100(2):371–5.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2017 Springer International Publishing Switzerland
About this chapter
Cite this chapter
Sipos, J.A. (2017). Ultrasound of the Thyroid and Soft Tissues of the Neck. In: Roman, S., Sosa, J., Solórzano, C. (eds) Management of Thyroid Nodules and Differentiated Thyroid Cancer. Springer, Cham. https://doi.org/10.1007/978-3-319-43618-0_3
Download citation
DOI: https://doi.org/10.1007/978-3-319-43618-0_3
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-43616-6
Online ISBN: 978-3-319-43618-0
eBook Packages: MedicineMedicine (R0)