Postoperative Surveillance of Thyroid Cancer: In View of a Radiologist

Jin Young Kwak

doi:10.11106/cet.2015.8.1.8

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Kwak: Postoperative Surveillance of Thyroid Cancer: In View of a Radiologist

Review Article

Clin Exp Thyroidol 2015;8(1):8-13.

Published online: 4 May 2015

DOI: https://doi.org/10.11106/cet.2015.8.1.8

Postoperative Surveillance of Thyroid Cancer: In View of a Radiologist

Jin Young Kwak

Department of Radiology, Severance Hospital, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, Korea

Correspondence: Jin Young Kwak, MD, Department of Radiology, Severance Hospital, Research Institute of Radiological Science, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Korea Tel: 82-2-2228-7400, Fax: 82-2-393-3035, E-mail: docjin@yuhs.ac

Received 2 May 2014 Accepted 9 June 2014

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Postoperative surveillance in patients with thyroid cancer is very important for radiologist to help the clinician manage the patient. The role of ultrasound is important but small volume tumor recurrence may not affect survival as well as its treatment may, at times, cause more morbid than its natural disease progression. In this review, I discuss postoperative surveillance in patients with thyroid cancer in the view of a radiologist.

Keywords: Thyroid cancer, Recurrence, Ultrasonography, Surveillance

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Fig. 1.

Several suspicious US features suggesting pathologic lymph nodes (arrows). (A) Hyperechogenicity. (B) Round shape. (C) Internal cystic change and calcifications.

Fig. 2.

Suture granuloma. Ill-defined ovoid hypoechoic nodules (arrows) with multiple internal echogenic foci (A, transverse scan and B, longitudinal scan).

Fig. 3.

A remnant thyroid tissue. After right thyroidectomy due to Hashimoto's thyroiditis, a heterogeneous oval hypoechoic lesion (arrows) was seen inferior to the inferior horn of a thyroid cartilage (arrowheads, A, transverse scan and B, longitudinal scan).

Fig. 4.

A traumatic neuroma. US shows a nodule with oval, heterogeneous, isochoic mass (arrows) with internal hyperechoic strands.

Table 1.

US feature suggesting a pathologic lymph node

Published year	Authors	Features
2003	Pacini et al.¹⁾	Clear hypoechoic, disomogeneous pattern, rounded or bulging shape without evidence of central halo
2004	Torlontano et al.²⁰⁾	4 mm or more, rounded shape, and/or presence of microcalcifications and/or cystic component adjunctive-absence of hyperechoic hilus and/or hypervascularization
2007	Leboulleux et al.²¹⁾	Cystic appearance, hyperechoic punctuations, loss of hilum, and peripheral vascularization, round shape, hypoechogenicity, and the loss of hilum
2008	Pelttari et al.²²⁾	New tissue growth in the thyroid bed or an enlarged, round lymph node without a fatty hyperechoic hilum
2010	Tuttle et al.²³⁾	Focal or diffuse hyperechogenicity, micro- or macrocalcification, cystic change, abnormal vascular pattern or a round shape (long=transverse diameter ratio<1.5)
2011	Yoon et al.²⁴⁾	Hyperechogenicity, cystic change, presence of calcifications, round shape, abnormal vascularity

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