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20-09-2016 | Endocrine cancers | Book chapter | Article

45. MR and CT Imaging of Thyroid Cancer

Authors: MD, FACR James Jelinek, MD Richard Young, MD Louis O. Smith III, MD Kenneth D. Burman

Publisher: Springer New York


Radiologic imaging is often not necessary for the preoperative staging of early thyroid carcinoma. However, with locally advanced disease, MRI and CT may be necessary to assess invasion of adjacent structures such as the esophagus, trachea, and neurovascular structures. Postoperative imaging of thyroid carcinoma is guided by the results of radioactive iodine metastatic disease for those patients with papillary and follicular carcinoma. With complete thyroidectomy and negative metastatic thyroid survey, imaging may not be necessary. For those patients with tumors that have non-avid iodine uptake and for those patients with medullary and anaplastic thyroid cancer, PET/CT is the modality of choice. For patients with metastatic disease, advanced imaging is required. Non-contrast CT is best for evaluating pulmonary nodules.
MRI is often best for identifying metastatic disease to the brain, upper neck, spine, liver, and skeletal structures.
New ablative technologies of cryoablation and RF ablation are available to treat metastatic thyroid carcinoma.
Interdisciplinary approach between endocrinologists, nuclear medicine physicians, and radiologists is essential to the diagnosis, staging, and treatment of advanced thyroid carcinoma.

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