Computed tomography of the thyroid ,88 and and9).9). CT scans are also the most sensitive diagnostic tool for the detection of pulmonary micro-metastases. Many of the neck US features that are considered as suggestive signs of disease recurrence are also applicable to CT examination. These signs might include sizable rounded nodules in the thyroid bed, fine calcifications, or cystic change. In cases of elevated thyroglobulin with negative neck US and iodine whole body scintigraphy (WBS), fluorodeoxyglucose (FDG) positron emission tomography (PET) is the next modality of choice. Dedifferentiated thyroid carcinoma usually has avid FDG-PET uptake and a negative radioiodine scan, typically does not respond to
Computed tomography of the thyroid aerodigestive axis or vascular structures are not technically possible in the absence of IV contrast administration. For these reasons, 18FDG-PET/CT utilizing contrast administration should be considered for most patients with extensive disease. Metastasis to the thyroid is rare and represents 5.5 % of biopsied thyroid malignancies. It is commonly found with cancers originating from the breast, renal cell, lung, melanoma, and colon. Direct invasion from adjacent structures such as the pharynx, larynx, trachea, or oesophagus has been reported (Fig. 10). Metastatic disease has a non-specific appearance. Presence of ITNs in patients with another known malignancy is a common clinical problem