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Further evaluation with ultrasound is required for patients less than 35 years old with nodules measuring more than 1 cm in the axial plane. The cutoff size for further evaluation is raised to 1.5 cm for patients more than 35 years old. This recommendation should be applied to the largest thyroid nodule in cases of multiple thyroid nodules.
Solitary thyroid nodules are more common in females yet more worrisome in males. Other associations with neoplastic nodules are family history of thyroid cancer and prior radiation to the head and neck. Solitary thyroid nodules are mostly benign colloid nodules. The second most common type is follicular adenoma. [26]
Treatment of a thyroid nodule depends on many things including size of the nodule, age of the patient, the type of thyroid cancer, and whether or not it has spread to other tissues in the body. If the nodule is benign, patients may receive thyroxine therapy to suppress thyroid-stimulating hormone and should be reevaluated in six months. [2]
If ultrasound results are equivocal or unclear, or if the thyroid nodule is small (typically less than 1 cm), the nodule can be monitored over time with serial ultrasounds. [10] Ultrasound has a sensitivity of 64-77% and a specificity of 82-90% for the detection of thyroid cancer. [10]
The Cancer Imaging Archive (TCIA) is an open-access database of medical images for cancer research. The site is funded by the National Cancer Institute's (NCI) Cancer Imaging Program, and the contract is operated by the University of Arkansas for Medical Sciences. Data within the archive is organized into collections which typically share a ...
Low uptake suggests thyroiditis, high uptake suggests Graves' disease, [5] and unevenness in uptake suggests the presence of a nodule. [citation needed] 123 I has a shorter half-life than 131 I (a half day vs. 8.1 days), so use of 123 I exposes the body to less radiation, at the expense of less time to evaluate delayed scan images. [6]
The thyroid ultrasound is also very effective to discover microcarcinomas, which refer to very small carcinomas (<1 cm). Papillary thyroid carcinomas are also discovered when a hard nodule is found in multinodular goiter, when enlarged cervical lymph nodes are detected, or when there are unidentified metastatic lesions elsewhere in the body. [5]
Anaplastic thyroid cancer seen on an ultrasound image Anaplastic thyroid carcinoma cells. ATC is considered an emergency cancer diagnosis since it poses a high risk of blocking the airway and/or esophagus due to its rapid growth in the neck, either of which can quickly cause a person's death by asphyxiation, if not immediately corrected. [2]