US for Thyroid Cancer: Diagnosis, Surveillance, and Treatment (How-to Workshop)

RC731

US for Thyroid Cancer: Diagnosis, Surveillance, and Treatment (How-to Workshop)

Refresher/Informatics — Neuroradiology, Ultrasound, Head and Neck, Oncologic Imaging,

Presented on December 4, 2014

Jill Eve Langer MD, Presenter: Consultant, BioClinica, Inc

Kathryn Ann Robinson MD, Presenter: Nothing to Disclose

Sheila Sheth MD, Presenter: Consultant, Star Scientific, Inc

1) Describe the sonographic characteristics of thyroid nodules that are suspicious for malignancy. 2) a. Discuss the Bethesda Cytology Classification of Thyroid FNA results and the risk of malignancy associated with each category. b. Describe the indications for two new genetic tests that may be performed on FNAs obtained from thyroid nodules with indeterminate cytology. 3) a. Describe the technique of US-guided biopsy of thyroid nodules and cervical lymph nodes in patients who have undergone thyroidectomy for thyroid cancer. b. Discuss the rationale and method of performance of US-guided ethanol ablation of malignant cervical adenopathy in post thyroidedctomy patients.

This presentation will consist of a three individual presentations. The first will review the sonographic characteristics of thyroid nodules that are suggestive of malignancy. Recommendations for selecting which thyroid nodules require ultrasound-guided biopsies which have been provided by both Radiology consensus conferences and published Endocrinology guidelines will be discussed. The second presentation will review with the Bethesda Cytology Classification of Thyroid FNA results and the risk of malignancy associated with each category. Additionally this presentation describes the indications for two new genetic tests that may be performed on FNAs obtained from thyroid nodules with indeterminate cytology. The last presentation will provide a detailed description of the technique for performing ultrasound guided biopsy of thyroid nodules and cervical lymph nodes. Various methods will be discussed and required equipment outlined. Possible complications, though rare, will be described. A comparison of the typical sonographic features of normal versus abnormal lymph nodes will be presented in an effort to identify those patients in whom sonographic follow up can be used instead of biopsy. A discussion of the possible advantages of adding thyroglobulin assay to cytologic evaluation will be provided. The rationale for and technique of performing ultrasound guided ethanol ablation of malignant cervical lymph nodes in patients with thyroid cancer will be undertaken.