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
Thyroid peroxidase body primarily as iodide, I. After entering the thyroid follicle (or thyroid follicular cell) via a Na/I symporter (NIS) on the basolateral side, iodide is shuttled across the apical membrane into the colloid via pendrin, after which thyroid peroxidase oxidizes iodide to atomic iodine (I) or iodinium (I). The "organification of iodine," the incorporation of iodine into thyroglobulin for the production of thyroid hormone, is nonspecific; that is, there is no TPO-bound intermediate, but iodination occurs via reactive iodine species released from TPO. The chemical reactions catalyzed by thyroid peroxidase occur on the outer apical membrane surface and are mediated