Thyroid Gland Imaging

Approach to incidental thyroid nodules on imaging Thyroid cancer is the fastest increasing cancer in the USA. An exponential increase in incidence of thyroid cancer has been partly attributed to an increased work-up of incidentally detected thyroid nodules on imaging, especially ultrasound and CT. Excessive workup of incidental thyroid nodules and overdiagnosis of subclinical cancers is a costly healthcare problem. Although radiologists fear missing malignancies, the prognosis for most small localized small papillary cancers is excellent, even without treatment. The ACR white paper on incidental thyroid findings was published to guide the evaluation of incidental thyroid nodules detected on ultrasound, CT and MRI, and nuclear medicine studies (1). The criteria for workup with dedicated ultrasound is based on suspicious findings, nodule size, and comorbidities.