Incidental thyroid nodule

doi:10.1136/bmj.b611

Published 4 March 2009, doi:10.1136/bmj.b611
Cite this as: BMJ 2009;338:b611

Practice

Rational Imaging

Incidental thyroid nodule

Chirag N Patel, specialist registrar in radiology ¹, Georgina Gerrard, consultant clinical oncologist², Andrew F Scarsbrook, consultant radiologist and nuclear medicine physician¹

¹ Departments of Radiology and Nuclear Medicine, St James’s University Hospital, Leeds Teaching Hospital, Leeds LS9 7TF, ² Department of Clinical Oncology, St James’s University Hospital, Leeds Teaching Hospital, Leeds LS9 7TF

Correspondence to: A F Scarsbrook andrew.scarsbrook@leedsth.nhs.uk

Thyroid nodules may be coincidentally detected as a result ofneck imaging, and most are benign; the authors discuss how bestto decide which nodules are most likely to be malignant andrequire further evaluation

The first 150 words of the full text of this article appear below.

Thyroid nodules are very common, and the overwhelmingmajority are benign
Thyroid nodules may be coincidentally detectedas a result of the increasing use of neck imaging
No imagingmodality can reliably differentiate between benign and malignantthyroid nodules, but ultrasonography is the best technique forevaluating nodules and triaging those that require histologicalevaluation
Ultrasound guided fine needle aspiration cytologyis accurate, cheap, and safe in most cases, but local resourcesvary
Metabolically active thyroid nodules detected on fusedpositron emission tomography and computed tomography (PET-CT)are associated with a 1 in 3 chance of malignancy and shouldbe further evaluated
PET-CT may have a future role in reducingunnecessary surgery in patients with indeterminate cytologybecause of its high negative predictive value

A 78 year old man presented with haemoptysis and was found tohave a bronchial tumour at bronchoscopy. He was referred fora ¹⁸fluorine fluorodeoxyglucose PET-CT . . . [Full text of this article]

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