What are the ATA guidelines on preoperative imaging for thyroid cancer surgery?

Updated: May 14, 2020
  • Author: Pramod K Sharma, MD; Chief Editor: Arlen D Meyers, MD, MBA  more...
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A 2015 consensus statement from the American Thyroid Association on preoperative imaging for thyroid cancer surgery stated the following [1, 2] :

  • Ultrasonography remains the most important imaging modality in the evaluation of thyroid cancer and should be used routinely to assess the primary tumor and all associated cervical lymph node basins preoperatively; positive lymph nodes may be distinguished from normal nodes based on size, shape, echogenicity, hypervascularity, loss of hilar architecture, and the presence of calcifications

  • Ultrasonographically guided fine-needle aspiration of suspicious lymph nodes may be useful in guiding the extent of surgery

  • Cross-sectional imaging (CT scanning with contrast or magnetic resonance imaging [MRI]) may be considered in select circumstances to better characterize tumor invasion and bulky, inferiorly located, or posteriorly located lymph nodes; it may also be used when ultrasonographic expertise is not available

  • The above recommendations are applicable to initial and revision surgery; functional imaging with positron emission tomography (PET) or PET-CT scanning may be helpful in cases of recurrent cancer with positive tumor markers and negative anatomic imaging

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