A narrative review of the role of cross-sectional imaging in the management of thyroid carcinoma: Imaging guidelines and T-CIRADS

Abstract

ABSTRACT Thyroid cancer is the most common endocrine malignancy and cross-sectional imaging plays an increasing role in management, especially for pre-surgical staging. It is important for the radiologist to know about the invasive nature of thyroid carcinoma and to highlight key imaging findings in the report thus permitting better surgical planning and improving surgical outcomes. For this review, we performed a comprehensive search of abstracts regarding the pre-operative markers in thyroid carcinoma and their key implications. We searched in PubMed, Cochrane CENTRAL, MEDLINE, Embase, and Google Scholar. This review article focuses on the major changes and key pre-surgical cross-sectional imaging findings mentioned in the 8th edition of the American Joint Committee on Cancer staging and the manner in which these changes should be incorporated in radiology reports. We conclude that the behavior and appearance of locally invasive thyroid cancer on computed tomography are crucial for the pre-operative evaluation of thyroid carcinoma. We also discuss synoptic reporting for thyroid malignancies, that is, T-CIRADS. Total thyroidectomy with possible removal of adjacent infiltrated critical structures along with neck dissection and post-operative risk stratification according to the American Thyroid Association is essential for an optimal curative result and survival.