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Thyroid imaging: nonisotopic techniques 

Thyroid imaging: nonisotopic techniques
Chapter:
Thyroid imaging: nonisotopic techniques
Author(s):

Laszlo Hegedüs

and Finn N. Bennedbæk

DOI:
10.1093/med/9780199235292.003.3067
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date: 18 June 2019

Clinical examination and evaluation of thyroid function remain fundamental in the evaluation of thyroid disorders, but observer variation leads to a considerable heterogeneity in the evaluation of patients with suspected thyroid disease (1). It is not surprising, therefore, that imaging of the thyroid is often performed. Although it most often cannot distinguish between benign and malignant lesions, and its clinical value is generally thought to be limited (2), a European survey demonstrated that 88% of European Thyroid Association members would use imaging in an index case of a euthyroid patient with a solitary thyroid nodule and absence of clinical suspicion of malignancy (3). In the case of a clinically benign nontoxic multinodular goitre, the figure was 91% (4).

The thyroid gland can be evaluated by several different nonisotopic imaging techniques. The most commonly used are ultrasonography, CT, and MRI. Each method has advantages and limitations, and there is no absolute clinical indication for performing any of these imaging procedures in the majority of patients. The major drawback of all techniques, in addition to expense, is that the technical advances in thyroid imaging have not been accompanied by increased specificity for tissue diagnosis. This chapter will focus on the clinical use of these methods and, as far as this is possible, compare their advantages and disadvantages (Table 3.1.6.1.1).

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