What is the role of imaging studies in the workup of papillary thyroid carcinoma (PTC)?

Updated: Jun 18, 2020
  • Author: Ponnandai S Somasundar, MD, MPH, FACS; Chief Editor: Neetu Radhakrishnan, MD  more...
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Answer

Chest radiography, computed tomography (CT), and magnetic resonance imaging (MRI) are not usually used in the initial workup of a thyroid nodule. National Comprehensive Cancer Network (NCCN) guidelines recommend CT or MRI for the evaluation of fixed, bulky, or substernal lesions. [8] Chest x-ray may be considered in patients with apparent metastatic disease at presentation.

A study by Choi et al concluded that preoperative [18F]fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET)/CT did not provide any additional information compared with neck sonography in patients with papillary thyroid carcinoma. [41]

Cabrera et al reported that single-photon emission computed tomography (SPECT)/CT and radioguided sentinel lymph node biopsy (rSLNB) can affect therapy by detecting occult cervical lymph node metastases in patients with papillary thyroid carcinoma. In their study, rSLNB results prompted management changes in 14 of 37 patients, with use of higher radioiodine ablation doses and closer clinical surveillance. [42]


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