Course Description
Thyroid nodules (TNs) are common in the general patient population and in clinical primary care settings and are considered to be one of the most common endocrine system abnormalities. TNs are discrete lesions that can be radiologically and pathologically differentiated from normal thyroid parenchyma. Distinguishing a benign from a malignant nodule can be challenging, and professional guidelines have assisted with standardizing their evaluation, management, and follow-up procedures. Thyroid ultrasound (TUS) is easily accessible, noninvasive, and cost-effective, and is a key imaging study for diagnosing and managing patients with TNs. TUS can also assess the patient for malignancy risk, ultimately determining if a nodule requires biopsy. Adjunct TUS techniques such as color Doppler, 3-dimensional (3D) sonography, elastography, and contrast enhancement may also assist with a patient's workup. Nuclear medicine and imaging can also play a part in managing patients with TNs, specifically with radioactive iodine uptake/thyroid uptake and thyroid scintigraphy, both of which allow more detailed evaluation. This course will review the anatomy of the thyroid, outline risk factors for developing thyroid cancer, as well as the types and stages of thyroid cancer. Sonographic imaging techniques used in managing patients with TNs will be described, including 3D sonography, color Doppler, elastography, and contrast-enhanced sonography as well as circumstances that would warrant TN biopsy. Fine-needle aspiration biopsy equipment, patient management, and procedures will be reviewed. Finally, a discussion of the basic concepts of nuclear imaging and techniques commonly used in thyroid imaging, including scintigraphy, radioactive iodine uptake procedures, radiotracers, radiotracer administration and dosing, and uptake calculations will also be detailed. Pictorial examples of TNs in various stages, in all discussed modalities, are included.

Learning Objectives
After completing this course, the participant should be able to:

• IDENTIFY the anatomy and function of the thyroid gland.
• OUTLINE risk factors, significant clinical history, physical examination procedures, and laboratory test results for patients who may be at risk for developing thyroid cancer.
• EXPLAIN the most common types of benign and malignant thyroid nodules (TNs).
• SUMMARIZE the primary role of, the benefits of, and drawbacks of using 2-dimensional B-mode grayscale sonography in the evaluation of patients with TNs.
• ANALYZE sonographic techniques for TN imaging including color Doppler, 3-dimensional, contrast-enhancement, and elastography.
• COMPARE and CONTRAST the American College of Radiology's Thyroid Imaging Reporting and Data System (TI-RADS) and the American Thyroid Association's Management Guidelines for classifying and staging TNs with sonography as well as their evaluation criteria for performing a fine-needle aspiration biopsy of the thyroid.
• EXPLAIN the role and application of nuclear medicine techniques pertaining to TNs using radiotracers with thyroid uptake and scan procedures.
• SUMMARIZE the primary role of, the benefits of, and drawbacks of using thyroid uptake and scan procedures in the evaluation of patients with TNs.

Categories: Sonography, Nuclear Medicine

In order to receive CE credit, you must first complete the activity content. When completed, go to the "Take CE Test!" link to access the post-test.

Submit the completed answers to determine if you have passed the post-test assessment. You must answer 29 out of 38 questions correctly to receive the CE credit. You will have no more than 3 attempts to successfully complete the post-test.

Participants successfully completing the activity content and passing the post-test will receive 4.0 ARRT Category A credits.

Approved by the American Society of Radiologic Technologists for ARRT Category A credit.

Approved by the state of Florida for ARRT Category A credit (for Technical credits).

Texas direct credit.

This activity may be available in multiple formats or from different sponsors. ARRT does not allow CE activities such as Internet courses, home study programs, or directed readings to be repeated for CE credit in the same biennium.