Thyroid Ultrasound and Ultrasound-Guided FNA

Transcription

1 Thyroid Ultrasound and Ultrasound-Guided FNA

2

3 H. Jack Baskin, Sr. Daniel S. Duick Robert A. Levine Editors Thyroid Ultrasound and Ultrasound-Guided FNA Third Edition

4 Editors H. Jack Baskin, Sr. University of Central Florida Orlando, FL, USA Daniel S. Duick Endocrinology Associates, PA Scottsdale, AZ, USA Robert A. Levine Thyroid Center of New Hampshire Nashua, NH, USA ISBN ISBN (ebook) DOI / Springer New York Heidelberg Dordrecht London Library of Congress Control Number: Springer Science+Business Media, LLC 2000, 2008, 2013 This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of the material is concerned, speci fi cally the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on micro fi lms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. Exempted from this legal reservation are brief excerpts in connection with reviews or scholarly analysis or material supplied speci fi cally for the purpose of being entered and executed on a computer system, for exclusive use by the purchaser of the work. Duplication of this publication or parts thereof is permitted only under the provisions of the Copyright Law of the Publisher's location, in its current version, and permission for use must always be obtained from Springer. Permissions for use may be obtained through RightsLink at the Copyright Clearance Center. Violations are liable to prosecution under the respective Copyright Law. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a speci fi c statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. While the advice and information in this book are believed to be true and accurate at the date of publication, neither the authors nor the editors nor the publisher can accept any legal responsibility for any errors or omissions that may be made. The publisher makes no warranty, express or implied, with respect to the material contained herein. Printed on acid-free paper Springer is part of Springer Science+Business Media (

5 Foreword This third edition of Thyroid Ultrasound and Ultrasound-Guided FNA by Drs. Baskin, Duick, and Levine expands upon the fi rst two editions, including new chapters and authors, and is an essential guide for endocrinologists, endocrine fellows, radiologists, general surgeons with an interest in thyroid and parathyroid surgery, and head and neck surgeons. Over the past decade, the incidence of thyroid cancer in the United States continues to rise (estimated to be 57,000 men and women during 2012), including those patients with more locally invasive and systemic disease. The use of sophisticated neck ultrasound to detect benign and malignant thyroid nodules, lymph nodes, and cysts, parathyroid adenomas, salivary gland tumors, and other neck lesions has markedly improved our ability to fi nd even smaller thyroid nodules, to help differentiate benign from malignant thyroid nodules and lymph nodes, and to con fi rm the presence of parathyroid adenomas. Several new and extremely informative chapters have been added to this third edition: the use of ultrasound in the pediatric population; mapping of neck lymph nodes; surgical trends in the management of thyroid nodules and cancer, and parathyroid disease; evaluation of the salivary glands and nonendocrine tumors; extensive use of thyroid cancer molecular markers in fi ne needle aspirates; and an up-to-date guideline on preparing ultrasound reports. The chapters on the use of laser and radiofrequency ablation of thyroid nodules and ultrasound elastography to differentiate between benign and malignant thyroid nodules are updated. Although these techniques are innovative, their practical use remains to be determined. This textbook is extremely informative and should be available to all physicians and trainees with an interest in the diagnostic and operative approach to thyroid and parathyroid disease. Lewis E. Braverman v

6

7 Preface to First Edition Over the past two decades, ultrasound has undergone numerous advances in technology, such as gray-scale imaging, realtime sonography, high resolution Mtz transducers, and colorflow Doppler that make ultrasound unsurpassed in its ability to provide very accurate images of the thyroid gland quickly, inexpensively, and safely. However, in spite of these advances, ultrasound remains drastically underutilized by endocrinologists. This is due in part to a lack of understanding of the ways in which ultrasound can aid in the diagnosis of various thyroid conditions, and to a lack of experience in ultrasound technique by the clinician. The purpose of this book is to demonstrate how ultrasound is integrated with the history, physical examination, and other thyroid tests (especially FNA biopsy) to provide valuable information that can be used to improve patient care. Numerous ultrasound examples are used to show the interactions between ultrasound and tissue characteristics and explain their clinical significance. Also presented is the work of several groups of investigators worldwide who have explored new applications of ultrasound that have led to novel techniques that are proving to be clinically useful. To reach its full potential, it is critical that thyroid ultrasound be performed by the examining physician. This book instructs the physician on how to perform the ultrasound at the bedside so that it becomes part of the physical examination. mong the new developments discussed are the new digital phased-array transducers that allow ultrasound and FNA biopsy to be combined in the technique of ultrasound-guided FNA biopsy. Over the next decade, this technique will become a part of our routine clinical practice and a powerful new tool in the diagnosis of thyroid nodules and in the follow-up of thyroid cancer patients. H. Jack Baskin, MD Editor vii

8

9 Preface to Second Edition In the eight years since the publication of the first edition of this book, ultrasound has become an integral part of the practice of endocrinology. Ultrasound guidance for obtaining accurate diagnostic material by FNA is now accepted normal procedure. As the chief editor of Thyroid wrote in a recent editorial: I do not know how anyone can see thyroid patients without their own ultrasound by their side. The widespread adoption of this new technology by clinicians in a relatively short span of time is unprecedented. While most endocrinologists now feel comfortable using ultrasound for the diagnosis of thyroid nodules, many are reluctant to expand its use beyond the thyroid. Its value as a diagnostic tool to look for evidence of thyroid cancer in neck lymph nodes, or to evaluate parathyroid disease is at least as great as it is in evaluating thyroid nodules. In this second edition, we continue to explore these diagnostic techniques that are readily available to all clinicians. Since the first edition, clinical investigators have continued to discover new techniques and applications for thyroid and neck ultrasound. Power Doppler has replaced color flow Doppler for examining blood flow in the tissues of the neck. Other new advances in diagnosis include ultrasound contrast media, ultrasound elastography, and harmonic imaging. The only ultrasound-guided therapeutic procedure addressed in the 2000 edition was percutaneous ethanol injection (PEI), which had not been reported from the United States but was commonly practiced elsewhere in the world. Today, other ultrasoundguided therapeutic procedures such as laser, radiofrequency, and high intensity focused ultrasound (HIFU) are being used for ablation of tissue without surgery. These innovative procedures are discussed by the physicians who are developing them. ix

10 x PREFACE TO SECOND EDITION We hope that this second edition will inspire clinicians to proceed beyond using ultrasound just for the diagnosis of nodular goiter. The benefits to patients will continue as clinicians advance neck ultrasound to its full potential. H. Jack Baskin, MD Editor, 2008

11 Preface to Third Edition The ninetieth century essayist, Frédéric Bastiat, in speaking of the qualities of a readable and enduring book, said: It must be short, clear, accurate and as full of feeling as of ideas; all at the same time. We have tried to adhere to these qualities in the current volume. As in the previous editions, we have chosen authors who have enthusiastically adapted ultrasound in the diagnosis and treatment of thyroid and ancillary disease of the neck. Each contributor has extensive hands-on experience and contributed to the accumulating knowledge in the field as well as being ardent teachers of this knowledge to others. Readers will notice some changes from past editions of this book. Some topics given complete chapters in previous editions have been combined into a single chapter. Other chapters have been expanded and new chapters have been added to encompass recent techniques such as employing UGFNA acquired material for molecular and genetic markers and using ultrasound guidance for radiofrequency ablation. A separate chapter on pediatric ultrasound and congenital abnormalities has been added. Other new chapters focus on the effect ultrasound has had on the surgical management of thyroid and parathyroid disease. Since the first publication of Thyroid Ultrasound and UGFNA in 2000, ultrasound has become established as a primary tool for diagnosing and managing thyroid disease. Indeed, over the last 10 years ultrasound has become a catalyst for bringing together endocrinologists, surgeons, radiologists, and pathologists to create a multidisciplinary approach to the management of thyroid disease which is and will continue to benefit our patients. Salt Lake City, UT, USA Henry J. Baskin xi

12

13 Contents 1 History of Thyroid Ultrasound... 1 Robert A. Levine 2 Thyroid Ultrasound Physics... 9 Robert A. Levine 3 Doppler Ultrasound of the Neck Robert A. Levine 4 Normal Neck Anatomy and Method of Performing Ultrasound Examination Dara R. Treadwell 5 Pediatric Ultrasound of the Neck Henry J. Baskin, Jr 6 Ultrasound of Diffuse Thyroid Enlargement: Thyroiditis Mark A. Lupo and Robert A. Levine 7 Ultrasound of Nodular Thyroid Enlargement Susan J. Mandel and Jill E. Langer 8 Ultrasound and Mapping of Neck Lymph Nodes Gregory Randolph, Barry Sacks, and H. Jack Baskin, Sr 9 Ultrasonography of the Parathyroid Glands Dev Abraham 10 Surgical Trends in Treatment of Thyroid Nodules, Thyroid Cancer, and Parathyroid Disease Haengrang Ryu, Rachel Harris, and Nancy D. Perrier 11 Ultrasound of Salivary Glands and the Non-endocrine Neck Robert A. Sofferman xiii

14 xiv CONTENTS 12 Ultrasound-Guided Fine-Needle: Aspiration of Thyroid Nodules Daniel S. Duick 13 Laser and Radiofrequency Ablation Procedures Roberto Valcavi, Giorgio Stecconi Bortolani, and Fabrizio Riganti 14 Percutaneous Ethanol Injection (PEI) in the Treatment of Thyroid Cysts, Nodules, and Other Neck Lesions Andrea Frasoldati and Roberto Valcavi 15 Ultrasound-Guided FNA and Molecular Markers for Optimization of Thyroid Nodule Management Daniel S. Duick 16 Ultrasound Elastography of the Thyroid Robert A. Levine 17 Authoring Quality Ultrasound Reports J. Woody Sistrunk and H. Jack Baskin, Sr Index

15 Contributors Robert A. Levine, MD, FACE, ECNU Thyroid Center of New Hampshire, Dartmouth Medical School, Nashua, NH, USA Dara R. Treadwell, BS, BT, RDMS Tavares, FL, USA Henry J. Baskin, Jr MD, DACR Department of Radiology, Primary Children s Medical Center, University of Utah School of Medicine, Salt Lake City, UT, USA Mark A. Lupo, MD, FACE, ECNU Florida State University College of Medicine, Thyroid & Endocrine Center of Florida, Sarasota, FL, USA Susan J. Mandel, MD, MPH Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA Jill E. Langer, MD Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA Gregory Randolph, MD, FACS General and Thyroid Surgical Divisions Mass Eye and Ear In fi rmary, Harvard Medical School, Boston, MA, USA Barry Sacks, MD Beth Israel Deaconess Medical Center, Natick, MA, USA H. Jack Baskin, Sr MD, MACE University of Central Florida College of Medicine, Orlando, FL, USA Dev Abraham, MD, MRCP University of Utah, Salt Lake City, UT, USA Haengrang Ryu, MD MD Anderson Cancer Center, Yonsei University College of Medicine, Seoul, South Korea xv

16 xvi CONTRIBUTORS Rachel Harris, MD Department of Surgical Oncology, MD Anderson Cancer Center, The University of Texas MD Anderson Cancer Center, Houston, TX, USA Nancy D. Perrier, MD, FACS Department of Surgical Oncology, Section of Surgical Endocrinology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA Robert A. Sofferman, MD University Vermont College of Medicine, Burlington, VT, USA Roberto Valcavi, MD, FACE Endocrinology Unit, Arcispedale Santa Maria Nuova, Reggio Emilia, Italy Giorgio Stecconi Bortolani, MD Endocrine Unit, Arcispedale Santa Maria Nuova, Reggio Emilia, Italy Fabrizio Riganti, MD Endocrine Unit, Arcispedale Santa Maria Nuova, Reggio Emilia, Italy Andrea Frasoldati, MD Endocrine Unit, Arcispedale Santa Maria Nuova, Reggio Emilia, Italy Daniel S. Duick, MD, FACP, FACE University of Arizona Health Sciences Center, Endocrinology Associates, PA, Scottsdale, AZ, USA J. Woody Sistrunk, MD, FACE, ECNU Jackson Thyroid and Endocrine Clinic, Jackson, MS, USA