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 without suspicious features should not undergo further evaluation. Nevertheless, further workup might be necessary for such individuals if it is clinically warranted, or specifically requested by the referring physician or the patient. In patients with ITNs, it is important to inquire about pertinent historical factors predicting malignancy. These factors include history of childhood or adolescent head and neck or total body radiation exposure, and familial thyroid carcinoma or thyroid cancer syndrome. Syndromes associated with thyroid cancer include multiple endocrine neoplasia 2, familial adenomatous polyposis, Carney complex, Cowden’s disease, and Werner syndrome/progeria. If a patient has a first-degree relative with such