Malignancy arising from epithelial thyroid cells with well-defined histology
Papillary or follicular with multiple variants
Papillary carcinoma, papillary adenocarcinoma
Tall cell, insular, and follicular (mixed) variants
Follicular carcinoma, follicular adenocarcinoma
Hürthle cell variant
IMAGING
General Features
CT Findings
MR Findings
Ultrasonographic Findings
Nuclear Medicine Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Staging, Grading, & Classification
Gross Pathologic & Surgical Features
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Selected References
Brauckhoff K et al: Multimodal imaging of thyroid cancer. Curr Opin Endocrinol Diabetes Obes. 27(5):335-44, 2020
Ciarallo A et al: Radioactive iodine therapy in differentiated thyroid cancer: 2020 update. AJR Am J Roentgenol. 215(2):285-91, 2020
Debnam JM et al: Distinguishing recurrent thyroid cancer from residual nonmalignant thyroid tissue using multiphasic multidetector CT. AJNR Am J Neuroradiol. 41(5):844-51, 2020
Hoang JK et al: Managing incidental thyroid nodules detected on imaging: white paper of the ACR Incidental Thyroid Findings Committee. J Am Coll Radiol. 12(2):143-50, 2015
Amin MB et al: AJCC Cancer Staging Manual. 8th ed. Springer, 2017
Noda Y et al: MRI of the thyroid for differential diagnosis of benign thyroid nodules and papillary carcinomas. AJR Am J Roentgenol. 204(3):W332-5, 2015
Samir AE et al: Shear-Wave elastography for the preoperative risk stratification of follicular-patterned lesions of the thyroid: diagnostic accuracy and optimal measurement plane. Radiology. 277(2):565-73, 2015
Zhang Y et al: Diagnostic radiography exposure increases the risk for thyroid microcarcinoma: a population-based case-control study. Eur J Cancer Prev. 24(5):439-46, 2015
Trybek T et al: The role of 18F-fluorodeoxyglucose positron emission tomography in patients with suspected recurrence or metastatic differentiated thyroid carcinoma with elevated serum thyroglobulin and negative I-131 whole body scan. Nucl Med Rev Cent East Eur. 17(2):87-93, 2014
Glazer DI et al: SPECT/CT evaluation of unusual physiologic radioiodine biodistributions: pearls and pitfalls in image interpretation. Radiographics. 33(2):397-418, 2013
Kato H et al: Necrotic cervical nodes: usefulness of diffusion-weighted MR imaging in the differentiation of suppurative lymphadenitis from malignancy. Eur J Radiol. 82(1):e28-35, 2013
Saindane AM: Pitfalls in the staging of cancer of thyroid. Neuroimaging Clin N Am. 23(1):123-45, 2013
Xue YL et al: Value of ¹³¹I SPECT/CT for the evaluation of differentiated thyroid cancer: a systematic review of the literature. Eur J Nucl Med Mol Imaging. 40(5):768-78, 2013
Aiken AH: Imaging of thyroid cancer. Semin Ultrasound CT MR. 33(2):138-49, 2012
Maruoka Y et al: Incremental diagnostic value of SPECT/CT with 131I scintigraphy after radioiodine therapy in patients with well-differentiated thyroid carcinoma. Radiology. 265(3):902-9, 2012
Seo YL et al: Detection of neck recurrence in patients with differentiated thyroid cancer: comparison of ultrasound, contrast-enhanced CT and (18)F-FDG PET/CT using surgical pathology as a reference standard: (ultrasound vs. CT vs. (18)F-FDG PET/CT in recurrent thyroid cancer). Eur Radiol. 22(10):2246-54, 2012
Wu LM et al: The accuracy of ultrasonography in the preoperative diagnosis of cervical lymph node metastasis in patients with papillary thyroid carcinoma: A meta-analysis. Eur J Radiol. 81(8):1798-805, 2012
Erdem G et al: Diffusion-weighted images differentiate benign from malignant thyroid nodules. J Magn Reson Imaging. 31(1):94-100, 2010
Hall FM: Identification, biopsy, and treatment of poorly understood premalignant, in situ, and indolent low-grade cancers: are we becoming victims of our own success? Radiology. 254(3):655-9, 2010
Heston TF et al: Molecular imaging in thyroid cancer. Cancer Imaging. 10(1):1-7, 2010
Mihailovic J et al: MRI versus ¹³¹I whole-body scintigraphy for the detection of lymph node recurrences in differentiated thyroid carcinoma. AJR Am J Roentgenol. 195(5):1197-203, 2010
Moon HJ et al: Can vascularity at power Doppler US help predict thyroid malignancy? Radiology. 255(1):260-9, 2010
Razfar A et al: Clinical usefulness of positron emission tomography-computed tomography in recurrent thyroid carcinoma. Arch Otolaryngol Head Neck Surg. 136(2):120-5, 2010
Wong KK et al: Hybrid SPECT-CT and PET-CT imaging of differentiated thyroid carcinoma. Br J Radiol. 82(982):860-76, 2009
Agarwal V et al: Indications for PET/CT in the head and neck. Otolaryngol Clin North Am. 41(1):23-49, v, 2008
Aygun N: Imaging of recurrent thyroid cancer. Otolaryngol Clin North Am. 41(6):1095-106, viii, 2008
Johnson NA et al: Postoperative surveillance of differentiated thyroid carcinoma: rationale, techniques, and controversies. Radiology. 249(2):429-44, 2008
King AD: Imaging for staging and management of thyroid cancer. Cancer Imaging. 8:57-69, 2008
Loevner LA et al: Cross-sectional imaging of the thyroid gland. Neuroimaging Clin N Am. 18(3):445-61, vii, 2008
Newman JG et al: Surgical approaches in thyroid cancer: what the radiologist needs to know. Neuroimaging Clin N Am. 18(3):491-504, viii, 2008
Rutherford GC et al: Nuclear medicine in the assessment of differentiated thyroid cancer. Clin Radiol. 63(4):453-63, 2008
Miyakoshi A et al: Magnetic resonance imaging of thyroid cancer. Top Magn Reson Imaging. 18(4):293-302, 2007
Cohen EG et al: Postoperative management of differentiated thyroid cancer. Otolaryngol Clin North Am. 36(1):129-57, 2003
Kinder BK: Well differentiated thyroid cancer. Curr Opin Oncol. 15(1):71-7, 2003
Gross ND et al: MRI detection of cervical metastasis from differentiated thyroid carcinoma. Laryngoscope. 111(11 Pt 1):1905-9, 2001
Frilling A et al: Value of preoperative diagnostic modalities in patients with recurrent thyroid carcinoma. Surgery. 128(6):1067-74, 2000
Leger AF et al: Upper retropharyngeal node involvement in differentiated thyroid carcinoma demonstrated by 131I scintigraphy. Br J Radiol. 73(876):1260-4, 2000
Muros MA et al: Utility of fluorine-18-fluorodeoxyglucose positron emission tomography in differentiated thyroid carcinoma with negative radioiodine scans and elevated serum thyroglobulin levels. Am J Surg. 179(6):457-61, 2000
Takashima S et al: Differentiated thyroid carcinomas. Prediction of tumor invasion with MR imaging. Acta Radiol. 41(4):377-83, 2000
Weber AL et al: The thyroid and parathyroid glands. CT and MR imaging and correlation with pathology and clinical findings. Radiol Clin North Am. 38(5): 1105-29, 2000
Mazzaferri EL: An overview of the management of papillary and follicular thyroid carcinoma. Thyroid. 9(5):421-7, 1999
Related Anatomy
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Related Differential Diagnoses
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References
Tables
Tables
KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Pathology
Clinical Issues
TERMINOLOGY
Abbreviations
Differentiated thyroid carcinoma (DTCa)
Definitions
Malignancy arising from epithelial thyroid cells with well-defined histology
Papillary or follicular with multiple variants
Papillary carcinoma, papillary adenocarcinoma
Tall cell, insular, and follicular (mixed) variants
Follicular carcinoma, follicular adenocarcinoma
Hürthle cell variant
IMAGING
General Features
CT Findings
MR Findings
Ultrasonographic Findings
Nuclear Medicine Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Staging, Grading, & Classification
Gross Pathologic & Surgical Features
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Selected References
Brauckhoff K et al: Multimodal imaging of thyroid cancer. Curr Opin Endocrinol Diabetes Obes. 27(5):335-44, 2020
Ciarallo A et al: Radioactive iodine therapy in differentiated thyroid cancer: 2020 update. AJR Am J Roentgenol. 215(2):285-91, 2020
Debnam JM et al: Distinguishing recurrent thyroid cancer from residual nonmalignant thyroid tissue using multiphasic multidetector CT. AJNR Am J Neuroradiol. 41(5):844-51, 2020
Hoang JK et al: Managing incidental thyroid nodules detected on imaging: white paper of the ACR Incidental Thyroid Findings Committee. J Am Coll Radiol. 12(2):143-50, 2015
Amin MB et al: AJCC Cancer Staging Manual. 8th ed. Springer, 2017
Noda Y et al: MRI of the thyroid for differential diagnosis of benign thyroid nodules and papillary carcinomas. AJR Am J Roentgenol. 204(3):W332-5, 2015
Samir AE et al: Shear-Wave elastography for the preoperative risk stratification of follicular-patterned lesions of the thyroid: diagnostic accuracy and optimal measurement plane. Radiology. 277(2):565-73, 2015
Zhang Y et al: Diagnostic radiography exposure increases the risk for thyroid microcarcinoma: a population-based case-control study. Eur J Cancer Prev. 24(5):439-46, 2015
Trybek T et al: The role of 18F-fluorodeoxyglucose positron emission tomography in patients with suspected recurrence or metastatic differentiated thyroid carcinoma with elevated serum thyroglobulin and negative I-131 whole body scan. Nucl Med Rev Cent East Eur. 17(2):87-93, 2014
Glazer DI et al: SPECT/CT evaluation of unusual physiologic radioiodine biodistributions: pearls and pitfalls in image interpretation. Radiographics. 33(2):397-418, 2013
Kato H et al: Necrotic cervical nodes: usefulness of diffusion-weighted MR imaging in the differentiation of suppurative lymphadenitis from malignancy. Eur J Radiol. 82(1):e28-35, 2013
Saindane AM: Pitfalls in the staging of cancer of thyroid. Neuroimaging Clin N Am. 23(1):123-45, 2013
Xue YL et al: Value of ¹³¹I SPECT/CT for the evaluation of differentiated thyroid cancer: a systematic review of the literature. Eur J Nucl Med Mol Imaging. 40(5):768-78, 2013
Aiken AH: Imaging of thyroid cancer. Semin Ultrasound CT MR. 33(2):138-49, 2012
Maruoka Y et al: Incremental diagnostic value of SPECT/CT with 131I scintigraphy after radioiodine therapy in patients with well-differentiated thyroid carcinoma. Radiology. 265(3):902-9, 2012
Seo YL et al: Detection of neck recurrence in patients with differentiated thyroid cancer: comparison of ultrasound, contrast-enhanced CT and (18)F-FDG PET/CT using surgical pathology as a reference standard: (ultrasound vs. CT vs. (18)F-FDG PET/CT in recurrent thyroid cancer). Eur Radiol. 22(10):2246-54, 2012
Wu LM et al: The accuracy of ultrasonography in the preoperative diagnosis of cervical lymph node metastasis in patients with papillary thyroid carcinoma: A meta-analysis. Eur J Radiol. 81(8):1798-805, 2012
Erdem G et al: Diffusion-weighted images differentiate benign from malignant thyroid nodules. J Magn Reson Imaging. 31(1):94-100, 2010
Hall FM: Identification, biopsy, and treatment of poorly understood premalignant, in situ, and indolent low-grade cancers: are we becoming victims of our own success? Radiology. 254(3):655-9, 2010
Heston TF et al: Molecular imaging in thyroid cancer. Cancer Imaging. 10(1):1-7, 2010
Mihailovic J et al: MRI versus ¹³¹I whole-body scintigraphy for the detection of lymph node recurrences in differentiated thyroid carcinoma. AJR Am J Roentgenol. 195(5):1197-203, 2010
Moon HJ et al: Can vascularity at power Doppler US help predict thyroid malignancy? Radiology. 255(1):260-9, 2010
Razfar A et al: Clinical usefulness of positron emission tomography-computed tomography in recurrent thyroid carcinoma. Arch Otolaryngol Head Neck Surg. 136(2):120-5, 2010
Wong KK et al: Hybrid SPECT-CT and PET-CT imaging of differentiated thyroid carcinoma. Br J Radiol. 82(982):860-76, 2009
Agarwal V et al: Indications for PET/CT in the head and neck. Otolaryngol Clin North Am. 41(1):23-49, v, 2008
Aygun N: Imaging of recurrent thyroid cancer. Otolaryngol Clin North Am. 41(6):1095-106, viii, 2008
Johnson NA et al: Postoperative surveillance of differentiated thyroid carcinoma: rationale, techniques, and controversies. Radiology. 249(2):429-44, 2008
King AD: Imaging for staging and management of thyroid cancer. Cancer Imaging. 8:57-69, 2008
Loevner LA et al: Cross-sectional imaging of the thyroid gland. Neuroimaging Clin N Am. 18(3):445-61, vii, 2008
Newman JG et al: Surgical approaches in thyroid cancer: what the radiologist needs to know. Neuroimaging Clin N Am. 18(3):491-504, viii, 2008
Rutherford GC et al: Nuclear medicine in the assessment of differentiated thyroid cancer. Clin Radiol. 63(4):453-63, 2008
Miyakoshi A et al: Magnetic resonance imaging of thyroid cancer. Top Magn Reson Imaging. 18(4):293-302, 2007
Cohen EG et al: Postoperative management of differentiated thyroid cancer. Otolaryngol Clin North Am. 36(1):129-57, 2003
Kinder BK: Well differentiated thyroid cancer. Curr Opin Oncol. 15(1):71-7, 2003
Gross ND et al: MRI detection of cervical metastasis from differentiated thyroid carcinoma. Laryngoscope. 111(11 Pt 1):1905-9, 2001
Frilling A et al: Value of preoperative diagnostic modalities in patients with recurrent thyroid carcinoma. Surgery. 128(6):1067-74, 2000
Leger AF et al: Upper retropharyngeal node involvement in differentiated thyroid carcinoma demonstrated by 131I scintigraphy. Br J Radiol. 73(876):1260-4, 2000
Muros MA et al: Utility of fluorine-18-fluorodeoxyglucose positron emission tomography in differentiated thyroid carcinoma with negative radioiodine scans and elevated serum thyroglobulin levels. Am J Surg. 179(6):457-61, 2000
Takashima S et al: Differentiated thyroid carcinomas. Prediction of tumor invasion with MR imaging. Acta Radiol. 41(4):377-83, 2000
Weber AL et al: The thyroid and parathyroid glands. CT and MR imaging and correlation with pathology and clinical findings. Radiol Clin North Am. 38(5): 1105-29, 2000
Mazzaferri EL: An overview of the management of papillary and follicular thyroid carcinoma. Thyroid. 9(5):421-7, 1999
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