Multimodal imaging of thyroid cancer

Area of Science:

• Endocrinology
• Oncology
• Radiology

Background:

• Thyroid cancer is the most common endocrine malignancy with increasing incidence.
• Accurate diagnosis and staging are crucial for effective surgical management.
• Distinguishing malignant from benign thyroid nodules remains a clinical challenge.

Purpose of the Study:

• To review the principles of optimal multimodal imaging for thyroid cancer.
• To assist clinicians in avoiding common pitfalls in thyroid cancer imaging.
• To discuss recent advancements in diagnostic imaging techniques.

Main Methods:

• Review of current literature and guidelines, including American Thyroid Association (ATA) recommendations.
• Assessment of ultrasound-based scoring systems for nodule selection.
• Evaluation of novel radioactive tracers for specific thyroid cancer types.

Main Results:

• Ultrasound with ultrasound-guided fine needle biopsy (FNB) is the primary diagnostic tool.
• Advanced imaging (CT, MRI, FDG-PET) is used for advanced or recurrent differentiated and anaplastic thyroid cancers.
• [F]FDOPA and [Ga]DOTATOC PET are preferred for medullary thyroid cancer.

Conclusions:

• Optimal multimodal imaging is essential for accurate thyroid cancer diagnosis and staging.
• New imaging techniques and scoring systems are improving patient selection and management.
• Adherence to established principles and awareness of pitfalls enhance clinical outcomes.