Magnetic Resonance Imaging of Thyroid Cancer

Miyakoshi, Asako; Dalley, Robert W.; Anzai, Yoshimi

doi:10.1097/rmr.0b013e318572b76

Cited by 33 publications

(13 citation statements)

References 27 publications

(26 reference statements)

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“…Preference around preoperative imaging was specifically investigated; ultrasonography is the most sensitive modality for staging lymph nodes but axial imaging (traditionally MRI) 26 may have a role for tumours with suspicion of local disease advancement 27 or in higher risk groups (eg scenario 5).…”

Section: Methodsmentioning

confidence: 99%

A cross-specialty survey to assess the application of risk stratified surgery for differentiated thyroid cancer in the UK

Ramsay¹,

Fielding²,

Krukowski

2014

annals

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INTRODUCTION This study describes variability of treatment for differentiated thyroid cancer among thyroid surgeons, in the context of changing patterns of thyroid surgery in the UK. METHODS Hospital Episodes Statistics on thyroid operations between 1997 and 2012 were obtained for England. A survey comprising six scenarios of varying 'risk' was developed. Patient/tumour information was provided, with five risk stratified or non-risk stratified treatment options. The survey was distributed to UK surgical associations. Respondent demographics were categorised and responses analysed by assigned risk stratified preference. RESULTS From 1997 to 2012, the Hospital Episode Statistics data indicated there was a 55% increase in the annual number of thyroidectomies with a fivefold increase in otolaryngology procedures and a tripling of cancer operations. Of the surgical association members surveyed, 264 respondents reported a thyroid surgery practice. Management varied across and within the six scenarios, and was not related consistently to the level of risk. Associations were demonstrated between overall risk stratified preference and higher volume practice (>25 thyroidectomies per year) (p=0.011), fewer years of consultant practice (p=0.017) and multidisciplinary team participation (p=0.037). Logistic regression revealed fewer years of consultant practice (odds ratio [OR]: 0.96/year in practice, 95% confidence interval [CI]: 0.922-0.997, p=0.036) and caseload of >25/year (OR 1.92, 95% CI: 1.044-3.522, p=0.036) as independent predictors of risk stratified preference. CONCLUSIONS There is a substantial contribution to thyroid surgery in the UK by otolaryngology surgeons. Adjusting management according to established case-based risk stratification is not widely applied. Higher caseload was associated with a preference for management tailored to individual risk.

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Section: Methodsmentioning

confidence: 99%

A cross-specialty survey to assess the application of risk stratified surgery for differentiated thyroid cancer in the UK

Ramsay¹,

Fielding²,

Krukowski

2014

annals

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“…MRI of the neck is mainly used for planning the surgical approach and postoperative follow-up in head and neck cancer and TC patients. Its specific application for TC has frequently been described in the literature [22, 24, 25]. The sensitivity and specificity of MRI in detecting locally recurrent or metastatic TC ranges from 0.76 to 0.95 and 0.51 to 0.98, respectively [4, 22, 24, 26].…”

Section: Introductionmentioning

confidence: 99%

Impact of combined FDG-PET/CT and MRI on the detection of local recurrence and nodal metastases in thyroid cancer

et al. 2016

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BackgroundSuspected recurrence of thyroid carcinoma is a diagnostic challenge when findings of both a radio iodine whole body scan and ultrasound are negative. PET/CT and MRI have shown to be feasible for detection of recurrent disease. However, the added value of a consensus reading by the radiologist and the nuclear medicine physician, which has been deemed to be helpful in clinical routines, has not been investigated. This study aimed to investigate the impact of combined FDG-PET/ldCT and MRI on detection of locally recurrent TC and nodal metastases in high-risk patients with special focus on the value of the multidisciplinary consensus reading.Materials and methodsForty-six patients with suspected locally recurrent thyroid cancer or nodal metastases after thyroidectomy and radio-iodine therapy were retrospectively selected for analysis. Inclusion criteria comprised elevated thyroglobulin blood levels, a negative ultrasound, negative iodine whole body scan, as well as combined FDG-PET/ldCT and MRI examinations.Neck compartments in FDG-PET/ldCT and MRI examinations were independently analyzed by two blinded observers for local recurrence and nodal metastases of thyroid cancer. Consecutively, the scans were read in consensus. To explore a possible synergistic effect, FDG-PET/ldCT and MRI results were combined. Histopathology or long-term follow-up served as a gold standard.For method comparison, sensitivity, specificity, positive and negative predictive values, and diagnostic accuracy were calculated.ResultsFDG-PET/ldCT was substantially more sensitive and more specific than MRI in detection of both local recurrence and nodal metastases. Inter-observer agreement was substantial both for local recurrence (κ = 0.71) and nodal metastasis (κ = 0.63) detection in FDG-PET/ldCT. For MRI, inter-observer agreement was substantial for local recurrence (κ = 0.69) and moderate for nodal metastasis (κ = 0.55) detection. In contrast, FDG-PET/ldCT and MRI showed only slight agreement (κ = 0.21). However, both imaging modalities identified different true positive results. Thus, the combination created a synergistic effect. The multidisciplinary consensus reading further increased sensitivity, specificity, and diagnostic accuracy.ConclusionsFDG-PET/ldCT and MRI are complementary imaging modalities and should be combined to improve detection of local recurrence and nodal metastases of thyroid cancer in high-risk patients. The multidisciplinary consensus reading is a key element in the diagnostic approach.Electronic supplementary materialThe online version of this article (doi:10.1186/s40644-016-0096-y) contains supplementary material, which is available to authorized users.

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“…In patients with large or fixed thyroid masses or bulky metastatic lymphadenopathy, US may be less sensitive at detecting metastatic disease to deep tissue regions, such as the superior mediastinum (level VII), the retropharyngeal, parapharyngeal, and subclavicular spaces (152,153). The addition of cross-sectional imaging using contrast-enhanced computed tomography (CT) or magnetic resonance imaging (MRI), depending on local expertise and preference, should be considered, especially if there is any concern for invasion of the aero-digestive tract (158)(159)(160)(161). If iodinated contrast agents are used, further evaluation and treatment with RAI may need to be delayed for 2-3 months until total body iodine burden decreases.…”

Section: Recommendation Rating: Imentioning

confidence: 99%

Management Guidelines for Children with Thyroid Nodules and Differentiated Thyroid Cancer

Francis

Waguespack

Bauer

et al. 2015

Thyroid

973

1,365

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Background: Previous guidelines for the management of thyroid nodules and cancers were geared toward adults. Compared with thyroid neoplasms in adults, however, those in the pediatric population exhibit differences in pathophysiology, clinical presentation, and long-term outcomes. Furthermore, therapy that may be recommended for an adult may not be appropriate for a child who is at low risk for death but at higher risk for long-term harm from overly aggressive treatment. For these reasons, unique guidelines for children and adolescents with thyroid tumors are needed. Methods: A task force commissioned by the American Thyroid Association (ATA) developed a series of clinically relevant questions pertaining to the management of children with thyroid nodules and differentiated thyroid cancer (DTC). Using an extensive literature search, primarily focused on studies that included subjects £ 18 years of age, the task force identified and reviewed relevant articles through April 2014. Recommendations were made based upon scientific evidence and expert opinion and were graded using a modified schema from the United States Preventive Services Task Force. Results: These inaugural guidelines provide recommendations for the evaluation and management of thyroid nodules in children and adolescents, including the role and interpretation of ultrasound, fine-needle aspiration cytology, and the management of benign nodules. Recommendations for the evaluation, treatment, and follow-up of children and adolescents with DTC are outlined and include preoperative staging, surgical management, postoperative staging, the role of radioactive iodine therapy, and goals for thyrotropin suppression. Management algorithms are proposed and separate recommendations for papillary and follicular thyroid cancers are provided.

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Magnetic Resonance Imaging of Thyroid Cancer

Cited by 33 publications

References 27 publications

A cross-specialty survey to assess the application of risk stratified surgery for differentiated thyroid cancer in the UK

A cross-specialty survey to assess the application of risk stratified surgery for differentiated thyroid cancer in the UK

Impact of combined FDG-PET/CT and MRI on the detection of local recurrence and nodal metastases in thyroid cancer

Management Guidelines for Children with Thyroid Nodules and Differentiated Thyroid Cancer

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