Why Thyroid Surgeons Are Frustrated with Radiologists: Lessons Learned from Pre- and Postoperative US. Radiographics 2016;36(7):2141-2153
Date
10/22/2016Pubmed ID
27768542DOI
10.1148/rg.2016150250Scopus ID
2-s2.0-84994893772 (requires institutional sign-in at Scopus site) 40 CitationsAbstract
Optimal treatment of thyroid cancer is highly dependent on accurate staging of the extent of disease at presentation. Preoperative ultrasonography (US) is the most sensitive method for detecting metastatic lymph nodes and is recommended as part of the standard preoperative workup. Missed findings on preoperative scans may lead to understaging and inadequate surgical management, which subsequently predispose these patients to residual disease postoperatively and a higher risk for recurrence, possibly requiring repeat surgery. Traditionally, thyroid US for pre- and postoperative staging has been performed by radiologists. However, there is a growing trend away from radiologist-performed US in favor of surgeon-performed US. Recent surgical and endocrinology literature has shown that, when compared with surgeon-performed US, radiologist-performed preoperative staging US is less accurate and is inadequate for presurgical planning, with higher local recurrence rates. This review highlights the importance of accurate preoperative US for patients with differentiated thyroid cancer, with specific attention to deficiencies that exist in general radiology department thyroid US reports. We present a standardized approach to neck US reporting that incorporates the newly updated 2015 recommendations from the American Thyroid Association and also addresses the pertinent questions for thyroid surgeons. By ensuring comprehensive preoperative assessment and improving thyroid US reporting, we seek to improve patient access to optimized care. ©RSNA, 2016.
Author List
Kumbhar SS, O'Malley RB, Robinson TJ, Maximin S, Lalwani N, Byrd DR, Wang CLMESH terms used to index this publication - Major topics in bold
Clinical CompetenceHumans
Perioperative Care
Prognosis
Radiologists
Radiology
Thyroid Neoplasms
Treatment Outcome
Ultrasonography
United States
