Thyroid Ultrasonography and Fine Needle Aspiration Biopsy: A Practical Guide and Picture Atlas

Ultrasound in Thyroid Cancer Surveillance

Author(s): Samer El-Kaissi and Jack R Wall

Pp: 63-68 (6)

DOI: 10.2174/9781681086859118010009

* (Excluding Mailing and Handling)

Abstract

Plasma thyroglobulin and neck ultrasound allow the detection of residual or recurrent disease in the majority of post-operative differentiated thyroid cancer patients. The two tests are complimentary to each other and are better than either test alone. Neck ultrasound is superior to neck palpation and allows morphological differentiation of benign from suspicious cervical lymph nodes. A baseline neck ultrasound is performed at 3-6 months post-operatively to examine the neck for persistent thyroid cancer and to plan for radioactive iodine ablation in patients at an increased risk for thyroid cancer recurrence. Neck ultrasonography is repeated periodically thereafter to exclude recurrent disease. Suspicious cervical lymph nodes and thyroid bed lesions can be biopsied under ultrasound guidance, and a needle washout obtained for measurement of thyroglobulin in patients with differentiated thyroid cancer and calcitonin in medullary thyroid cancer. Neck ultrasound also allows the examination of other anterior neck structures such as muscle and blood vessels for invasive disease and can be used to mark the location of suspicious nodes pre- or intraoperatively. In patients with elevated plasma tumour markers and negative neck ultrasound, whole body iodine scan or cross-sectional imaging may be useful.


Keywords: Anti-thyroglobulin antibody, Clinical neck palpation, Calcitonin, Cytopathology, Metastatic cervical lymph node, Neck ultrasound, Positron emission tomography, Recurrence of differentiated thyroid cancer, Thyroidectomy, Thyroid cancer, Thyroglobulin, Thyroid bed, Thyroid tissue remnant, Whole body iodine scan, Whole body single photon emission tomography.

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      • 13. app/Models/UserAccess/UserAccess.php:1266
      • 14. app/Http/Controllers/ChapterController.php:1518
      • 15. vendor/laravel/framework/src/Illuminate/Routing/Controller.php:54
      • 16. vendor/laravel/framework/src/Illuminate/Routing/ControllerDispatcher.php:43
      • 17. vendor/laravel/framework/src/Illuminate/Routing/Route.php:260
    • (select j.user_access_id,j.volume_id,j.user_id,j.from_ip,j.to_ip,j.type,j.track,"Trial Access" as access_base_text, CASE j.type WHEN 111 THEN true ELSE false END as terms_popup, "S" as content_download_type, null as restricted_user_access_key, null as restricted_user_access_type, CASE j.track WHEN 0 THEN false ELSE true END as tracksAccessByVolume,"chapter" as access_level, j.chapter_id from `user_access_chapter_trail` as `j` inner join `user_access_info` as `info` on `j`.`user_access_id` = `info`.`user_access_id` where ((j.from_ip <= 221975353 and j.to_ip >=221975353 )) and ((j.from_date <= 1740775246 and j.to_date >= 1740775246 and j.perpetual= 0) or (j.from_date is null and j.to_date is null and j.perpetual= 1)) and j.chapter_id = 12818) union (select j.user_access_id,j.volume_id,j.user_id,j.from_ip,j.to_ip,j.type,j.track,"Subscribed" as access_base_text, false as terms_popup, "S" as content_download_type, null as restricted_user_access_key, null as restricted_user_access_type, CASE j.track WHEN 0 THEN false ELSE true END as tracksAccessByVolume,"chapter" as access_level, j.chapter_id from `user_access_chapter_corporate` as `j` inner join `user_access_info` as `info` on `j`.`user_access_id` = `info`.`user_access_id` where ((j.from_ip <= 221975353 and j.to_ip >=221975353 )) and ((j.from_date <= 1740775246 and j.to_date >= 1740775246 and j.perpetual= 0) or (j.from_date is null and j.to_date is null and j.perpetual= 1)) and j.chapter_id = 12818) union (select j.user_access_id,j.volume_id,j.user_id,j.from_ip,j.to_ip,j.type,j.track,"Token Based Access" as access_base_text, false as terms_popup, "R" as content_download_type, j.uc_id as restricted_user_access_key, "v" as restricted_user_access_type, CASE j.track WHEN 0 THEN false ELSE true END as tracksAccessByVolume,"chapter" as access_level, j.chapter_id from `user_access_chapter_token` as `j` inner join `user_access_info` as `info` on `j`.`user_access_id` = `info`.`user_access_id` where ((j.from_ip <= 221975353 and j.to_ip >=221975353 )) and ((j.from_date <= 1740775246 and j.to_date >= 1740775246 and j.perpetual= 0) or (j.from_date is null and j.to_date is null and j.perpetual= 1)) and j.chapter_id = 12818)
      5.29msalphaeurekaselec_live_10_06_2022UserAccess.php#1266
      Backtrace
      • 13. app/Models/UserAccess/UserAccess.php:1266
      • 14. app/Http/Controllers/ChapterController.php:1549
      • 15. vendor/laravel/framework/src/Illuminate/Routing/Controller.php:54
      • 16. vendor/laravel/framework/src/Illuminate/Routing/ControllerDispatcher.php:43
      • 17. vendor/laravel/framework/src/Illuminate/Routing/Route.php:260
    • select b.banner_link, b.banner_name, b.banner_script, b.banner_remarks, b.banner_file_name, b.banner_placement, bd.content_type, bd.content_id from `tbl_banner` as `b` inner join `tbl_banner_detail` as `bd` on `bd`.`banner_id` = `b`.`banner_id` inner join `users` as `u` on `u`.`id` = `b`.`updated_by` where `b`.`banner_ebook` = 1 and `bd`.`content_type` = 'B' and `bd`.`content_id` = 2636 and `b`.`banner_from_date` <= 1740775246 and `b`.`banner_to_date` >= 1740775246 and `b`.`banner_status` = 'A' order by `b`.`banner_id` desc
      17.92msalphaeurekaselec_live_10_06_2022Banner.php#95
      Bindings
      • 0: 1
      • 1: B
      • 2: 2636
      • 3: 1740775246
      • 4: 1740775246
      • 5: A
      Backtrace
      • 13. app/Models/Banner.php:95
      • 14. app/Http/helpers.php:404
      • 17. vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • 18. vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
      • 19. vendor/laravel/framework/src/Illuminate/View/Engines/CompilerEngine.php:73
    • select count(*) as aggregate from `uc_cart_products` where cart_id='104aba13ca17f65c650148c7beb83e3f'
      320μsalphaeurekaselec_live_10_06_2022Cart.php#271
      Backtrace
      • 15. app/Models/Cart.php:271
      • 16. view::layouts._header:291
      • 18. vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • 19. vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
      • 20. vendor/laravel/framework/src/Illuminate/View/Engines/CompilerEngine.php:73
    App\Models\Keywords
    15Keywords.php#?
    App\Models\Chapter
    1Chapter.php#?
    App\Models\Ebook
    1Ebook.php#?
        _token
        J7QSdyOMIcsAs9gGUxFYS1gxKqzSPdIP4XrSjBwg
        uc_cart_id
        104aba13ca17f65c650148c7beb83e3f
        _previous
        array:1 [ "url" => "https://alpha.eurekaselect.com/chapter/12818" ]
        _flash
        array:2 [ "old" => [] "new" => [] ]
        PHPDEBUGBAR_STACK_DATA
        []
        path_info
        /chapter/12818
        status_code
        200
        
        status_text
        OK
        format
        html
        content_type
        text/html; charset=UTF-8
        request_query
        []
        
        request_request
        []
        
        request_headers
        0 of 0
        array:17 [ "x-https" => array:1 [ 0 => "1" ] "host" => array:1 [ 0 => "alpha.eurekaselect.com" ] "priority" => array:1 [ 0 => "u=0, i" ] "cookie" => array:1 [ 0 => "wayfindertarget=eyJpdiI6IklET0tSRFZON0MrVk5IcnFJN2Zkc3c9PSIsInZhbHVlIjoicEMrNVVVVStnY0ovLzJVT0NIdERLOFp2Uk1PdXFsRXY2VTBkcW5Vd3lBcz0iLCJtYWMiOiJjNTY2NzI0YzYzNGI0OTZmNGEzMDc1ODMxYzJkYjFjZjA2NWFmYjRlZThjNmNhNjc4YzFkZjFmZjQyM2EzMmE1IiwidGFnIjoiIn0%3Dwayfindertarget=eyJpdiI6IklET0tSRFZON0MrVk5IcnFJN2Zkc3c9PSIsInZhbHVlIjoicEMrNVVVVStnY0ovLzJVT0NIdERLOFp2Uk1PdXFsRXY2VTBkcW5Vd3lBcz0iLCJtYWMiOiJjNTY2NzI0YzYzNGI0" ] "accept-encoding" => array:1 [ 0 => "gzip, deflate, br, zstd" ] "sec-fetch-dest" => array:1 [ 0 => "document" ] "sec-fetch-user" => array:1 [ 0 => "?1" ] "sec-fetch-mode" => array:1 [ 0 => "navigate" ] "sec-fetch-site" => array:1 [ 0 => "none" ] "accept" => array:1 [ 0 => "text/html,application/xhtml+xml,application/xml;q=0.9,image/avif,image/webp,image/apng,*/*;q=0.8,application/signed-exchange;v=b3;q=0.7" ] "user-agent" => array:1 [ 0 => "Mozilla/5.0 AppleWebKit/537.36 (KHTML, like Gecko; compatible; ClaudeBot/1.0; +claudebot@anthropic.com)" ] "upgrade-insecure-requests" => array:1 [ 0 => "1" ] "sec-ch-ua-platform" => array:1 [ 0 => ""Windows"" ] "sec-ch-ua-mobile" => array:1 [ 0 => "?0" ] "sec-ch-ua" => array:1 [ 0 => ""HeadlessChrome";v="129", "Not=A?Brand";v="8", "Chromium";v="129"" ] "cache-control" => array:1 [ 0 => "no-cache" ] "pragma" => array:1 [ 0 => "no-cache" ] ]
        request_cookies
        0 of 0
        array:1 [ "wayfindertarget" => null ]
        response_headers
        0 of 0
        array:5 [ "content-type" => array:1 [ 0 => "text/html; charset=UTF-8" ] "cache-control" => array:1 [ 0 => "no-cache, private" ] "date" => array:1 [ 0 => "Fri, 28 Feb 2025 20:40:46 GMT" ] "set-cookie" => array:2 [ 0 => "XSRF-TOKEN=eyJpdiI6ImcrMERDOFM4cmZCOHRwWEhXVjMzdWc9PSIsInZhbHVlIjoiK1ZpalZBNWYrNVdCNDFRcjhLa3E1YnpvZjNkSjFmc0RDcFZQN2lyWFQwdjlsWUtOYzlRK2pScURxbDFEUmQvOVloa0NZSmpScDdkR1VlWncvT2hGMXppQjUxdkUydU5iM085anl2aUhMeG8yakV0TmpObUtxcUkzSWxxZkZGTmUiLCJtYWMiOiIzNGRiNzQwYWZhYjEyNDNmM2RkZWFjNmEyYjJiZDYwZTc4OTI2ZjI5NDAzZDg4MDQwYWY5NjdjYjUxMmMwNjVmIiwidGFnIjoiIn0%3D; expires=Mon, 03 Mar 2025 08:40:46 GMT; Max-Age=216000; path=/; secure; samesite=laxXSRF-TOKEN=eyJpdiI6ImcrMERDOFM4cmZCOHRwWEhXVjMzdWc9PSIsInZhbHVlIjoiK1ZpalZBNWYrNVdCNDFRcjhLa3E1YnpvZjNkSjFmc0RDcFZQN2lyWFQwdjlsWUtOYzlRK2pScURxbDFEUmQvOVloa0NZS" 1 => "alphaeurekaselectnet_session=eyJpdiI6IjBaZnFEQ0YweFVZSVZzZ3hlNkhHZWc9PSIsInZhbHVlIjoiUmI3UUpsbTRFVXN4ZlFKWmpsVmdRc0RoSUpzMGZkcEY0a3hJOWR6T1pLNkRDVlladFBPcG9JUGxzNU5rNTZTaTZNNEtqMGozaVJCRXcxTnBRWThqS2d0cHBxOWx1a0NzUmxoSjBualhyTWZyUUJnK3RJRnVFakJvcDBRWTVGeEsiLCJtYWMiOiIxMTk5ZGUzZWMxZDYzMjZiYzY5ZDU0YmRkZDliYTE1ODdkYzljZTdjNGMwZTgyYmFjODhhNDM0ZWY2YWViMzlmIiwidGFnIjoiIn0%3D; path=/; secure; httponly; samesite=laxalphaeurekaselectnet_session=eyJpdiI6IjBaZnFEQ0YweFVZSVZzZ3hlNkhHZWc9PSIsInZhbHVlIjoiUmI3UUpsbTRFVXN4ZlFKWmpsVmdRc0RoSUpzMGZkcEY0a3hJOWR6T1pLNkRDVlladFBPcG9JUGx" ] "Set-Cookie" => array:2 [ 0 => "XSRF-TOKEN=eyJpdiI6ImcrMERDOFM4cmZCOHRwWEhXVjMzdWc9PSIsInZhbHVlIjoiK1ZpalZBNWYrNVdCNDFRcjhLa3E1YnpvZjNkSjFmc0RDcFZQN2lyWFQwdjlsWUtOYzlRK2pScURxbDFEUmQvOVloa0NZSmpScDdkR1VlWncvT2hGMXppQjUxdkUydU5iM085anl2aUhMeG8yakV0TmpObUtxcUkzSWxxZkZGTmUiLCJtYWMiOiIzNGRiNzQwYWZhYjEyNDNmM2RkZWFjNmEyYjJiZDYwZTc4OTI2ZjI5NDAzZDg4MDQwYWY5NjdjYjUxMmMwNjVmIiwidGFnIjoiIn0%3D; expires=Mon, 03-Mar-2025 08:40:46 GMT; path=/; secureXSRF-TOKEN=eyJpdiI6ImcrMERDOFM4cmZCOHRwWEhXVjMzdWc9PSIsInZhbHVlIjoiK1ZpalZBNWYrNVdCNDFRcjhLa3E1YnpvZjNkSjFmc0RDcFZQN2lyWFQwdjlsWUtOYzlRK2pScURxbDFEUmQvOVloa0NZS" 1 => "alphaeurekaselectnet_session=eyJpdiI6IjBaZnFEQ0YweFVZSVZzZ3hlNkhHZWc9PSIsInZhbHVlIjoiUmI3UUpsbTRFVXN4ZlFKWmpsVmdRc0RoSUpzMGZkcEY0a3hJOWR6T1pLNkRDVlladFBPcG9JUGxzNU5rNTZTaTZNNEtqMGozaVJCRXcxTnBRWThqS2d0cHBxOWx1a0NzUmxoSjBualhyTWZyUUJnK3RJRnVFakJvcDBRWTVGeEsiLCJtYWMiOiIxMTk5ZGUzZWMxZDYzMjZiYzY5ZDU0YmRkZDliYTE1ODdkYzljZTdjNGMwZTgyYmFjODhhNDM0ZWY2YWViMzlmIiwidGFnIjoiIn0%3D; path=/; secure; httponlyalphaeurekaselectnet_session=eyJpdiI6IjBaZnFEQ0YweFVZSVZzZ3hlNkhHZWc9PSIsInZhbHVlIjoiUmI3UUpsbTRFVXN4ZlFKWmpsVmdRc0RoSUpzMGZkcEY0a3hJOWR6T1pLNkRDVlladFBPcG9JUGx" ] ]
        session_attributes
        0 of 0
        array:5 [ "_token" => "J7QSdyOMIcsAs9gGUxFYS1gxKqzSPdIP4XrSjBwg" "uc_cart_id" => "104aba13ca17f65c650148c7beb83e3f" "_previous" => array:1 [ "url" => "https://alpha.eurekaselect.com/chapter/12818" ] "_flash" => array:2 [ "old" => [] "new" => [] ] "PHPDEBUGBAR_STACK_DATA" => [] ]
        ClearShow all
        Date ↕MethodURLData
        #12025-02-28 20:40:46GET/chapter/128181121917