Cine clips increase the detection of thyroid pyramidal lobe in routine thyroid sonogram

Area of Science:

• Endocrinology
• Surgical Oncology
• Radiology

Background:

• The thyroid pyramidal lobe is an anatomical variation that requires identification and resection during thyroid cancer surgery.
• Failure to resect the pyramidal lobe can lead to interval cancer in residual thyroid tissue.

Purpose of the Study:

• To determine the prevalence of the thyroid pyramidal lobe in patients with and without prior thyroidectomy.
• To optimize the ultrasonography protocol for identifying the thyroid pyramidal lobe during routine examinations.

Main Methods:

• A prospective study enrolled 1579 patients undergoing routine thyroid ultrasonography.
• A dedicated scanning protocol was established, including static images and a transverse cine loop from the isthmus to the hyoid bone.
• The presence and features of thyroid pyramidal lobes were evaluated and compared.

Main Results:

• The detection rate of thyroid pyramidal lobes in patients without thyroidectomy increased from 39.5% to 49.7% with the addition of cine-loop imaging.
• Cine-loops were particularly effective in detecting pyramidal lobes separated from the main lobe or in post-thyroidectomy patients.
• The enhanced protocol also identified pathologies on the thyroid pyramidal lobe, including benign and malignant nodules and Hashimoto's thyroiditis pseudo-nodules.

Conclusions:

• Dynamic assessment with cine-loop significantly increases the detection rate of the thyroid pyramidal lobe.
• Attention to the thyroid pyramidal lobe in pre-operative sonographic imaging can prevent incomplete thyroid gland removal during thyroidectomy.