Seminars in Ultrasound, CT and MRI RSS feed: Current Issue. Seminars in Ultrasound, CT and MRI is directed to all physicians involved in the performance and interpretation of ultrasound, computed tomography, and magnetic resonance imaging procedures. It is a timely source for the publication of new concepts and research findings directly applicable to day-to-day clinical practice. The articles describe the performance of various procedures together with the authors' approach to problems of interpretation. Each issue is devoted to one topic and all papers are by invitation only. 2012 Topics, Volume 32, Issues 1-6 February Imaging in Pregnancy and the Postpartum State April Thyroid Parathyroid June Imaging of the Aorta August Errors and Malpractice in Radiology October ENT Emergencies II December The Pulmonary Vasculature http://www.semultrasoundctmri.com/?rss=yesElsevier Inc.en © 2012 Elsevier Inc. All rights reserved. Seminars in Ultrasound, CT and MRI0887-2171332April 2012 © 2012 Elsevier Inc. All rights reserved. healthpermissions@elsevier.comhttp://www.semultrasoundctmri.com/article/PIIS0887217112000030/abstract?rss=yesThis issue of the Seminars in Ultrasound, CT, and MRI reviews a number of topics on the subject of the thyroid and parathyroid glands. These relatively small anatomic structures have gained in concern and have garnered more than their size-matched interest in the recent neuroimaging and general radiology literature. Thyroid disease, notably thyroid neoplasia, is a more prevalent and much more commonly diagnosed entity of late, with the increased concern of radiation exposure and radiation-induced tumors, increased use of thyroid imaging, and increased physician concerns and vigilance in the diagnosis of thyroid disease. In this issue, we have enlisted a distinguished group of authors to cover thyroid embryology, anatomy, imaging, and the diagnosis and therapy of common and some not-so-common thyroid lesions. The topic of the incidental thyroid lesion, or “incidentaloma,” is also covered. This is a common problem for most practicing radiologists. We hope that the reader will gain an appreciation of the entirety of thyroid disease, both inflammatory and neoplastic, and will also gain confidence in the recommendations that should accompany the discovery of these “incidentalomas.”Letter From the Guest Editors: Thyroid and Parathyroid ImagingC. Douglas Phillips, Deborah R. Shatzkes10.1053/j.sult.2012.01.002Seminars in Ultrasound, CT and MRI 33, 2 (2012)2012-04-01Seminars in Ultrasound, CT and MRI2012-04-01332S0887-2171(11)X0008-2103103http://www.semultrasoundctmri.com/article/PIIS0887217111001673/abstract?rss=yes The thyroid and parathyroid glands are cervical endocrine glands responsible for metabolism-related functions. Radiologists are frequently asked to evaluate pathology related to the thyroid and parathyroid glands before planned surgical intervention. Knowledge of embryology and anatomy is fundamental in this region because rather complex underlying embryology produces substantial anatomic variation both in the thyroid bed and elsewhere in the neck and mediastinum. Anatomy and Embryology of the Thyroid and Parathyroid GlandsBruno A. Policeni, Wendy R.K. Smoker, Deborah L. Reede10.1053/j.sult.2011.12.005Seminars in Ultrasound, CT and MRI 33, 2 (2012)2012-04-01Seminars in Ultrasound, CT and MRI2012-04-01332S0887-2171(11)X0008-2104114http://www.semultrasoundctmri.com/article/PIIS0887217112000066/abstract?rss=yes Operative intervention on the parathyroid and thyroid glands has become more minimally invasive and selective over the past decade. This requires high-quality preoperative imaging evaluation for better knowledge of the relevant anatomical considerations and potential localization. Minimally invasive parathyroidectomy has become the operation of choice for most patients presenting with sporadic primary hyperparathyroidism (when the suspected parathyroid tumor is localized preoperatively). Preoperative imaging helps guide the surgeon as to which patients with thyroid pathology require intervention and the extent of resection. The imaging modalities reviewed include ultrasonography, technetium-99m sestamibi imaging, and four-dimensional computed tomography. Imaging modalities are discussed within the categories of benign and neoplastic parathyroid and thyroid pathology. Modern Approach to Surgical Intervention of the Thyroid and Parathyroid GlandsRachel Harris, Haengrang Ryu, Thinh Vu, Edmund Kim, Beth Edeiken, Elizabeth G. Grubbs, Nancy D. Perrier10.1053/j.sult.2012.01.005Seminars in Ultrasound, CT and MRI 33, 2 (2012)2012-04-01Seminars in Ultrasound, CT and MRI2012-04-01332S0887-2171(11)X0008-2115122http://www.semultrasoundctmri.com/article/PIIS088721711100165X/abstract?rss=yes Parathyroid imaging is performed in the setting of primary hyperparathyroidism with intent to localize adenomatous parathyroid tissue before minimally invasive surgery. Available imaging options currently consist of ultrasound, radionuclide scanning, magnetic resonance imaging, and both conventional and “4 D” computed tomography. Various combinations of these modalities are used based primarily on institutional bias, and although highly successful in localizing the common single adenoma, they are less effective when there is multiglandular disease or glandular ectopia. Imaging of the Parathyroid GlandsC. Douglas Phillips, Deborah R. Shatzkes10.1053/j.sult.2011.12.003Seminars in Ultrasound, CT and MRI 33, 2 (2012)2012-04-01Seminars in Ultrasound, CT and MRI2012-04-01332S0887-2171(11)X0008-2123129http://www.semultrasoundctmri.com/article/PIIS0887217112000029/abstract?rss=yes Infectious and autoimmune diseases account for the majority of benign conditions of the thyroid gland. They are usually diagnosed and followed by clinical examination and laboratory analyses, but when imaged, ultrasonography and computed tomography are the modalities of choice. In particular, fine needle aspiration under ultrasound guidance may be invaluable for diagnostic and therapeutic purposes. Benign Conditions of the Thyroid GlandAmy Fan-Yee Juliano, Mary Beth Cunnane10.1053/j.sult.2012.01.001Seminars in Ultrasound, CT and MRI 33, 2 (2012)2012-04-01Seminars in Ultrasound, CT and MRI2012-04-01332S0887-2171(11)X0008-2130137http://www.semultrasoundctmri.com/article/PIIS0887217111001685/abstract?rss=yes Thyroid cancer is a heterogeneous group of malignancies, including differentiated thyroid carcinomas, medullary and anaplastic carcinomas, and non-Hodgkin lymphoma. The incidence, presentation, natural history, prognosis, and treatment vary greatly among this diverse group of malignancies. The primary role of imaging in thyroid cancer is to evaluate for extension of tumor beyond the thyroid capsule and to assess for nodal metastases. Ultrasound is the standard imaging option for uncomplicated thyroid cancer, but patients with symptoms suggesting extrathyroidal extension or palpable lateral lymphadenopathy should be considered for cross-sectional imaging with computed tomography or magnetic resonance imaging. Imaging of Thyroid CancerAshley H. Aiken10.1053/j.sult.2011.12.006Seminars in Ultrasound, CT and MRI 33, 2 (2012)2012-04-01Seminars in Ultrasound, CT and MRI2012-04-01332S0887-2171(11)X0008-2138149http://www.semultrasoundctmri.com/article/PIIS0887217111001661/abstract?rss=yes The incidental thyroid nodule is a common finding on cross-sectional imaging of the neck and chest. Although the majority of nonpalpable incidental nodules are benign, the radiologist must assess the risk of malignancy, intelligently report the finding, and potentially direct the subsequent workup. To do so, the radiologist requires an understanding of issues around thyroid cancer, costs of thyroid nodule workup, and suspicious findings for malignancy. This article describes the problem of the incidental thyroid nodule, reviews the imaging findings of malignancy, and discusses an approach to reporting the incidental thyroid nodule. What to Do With Incidental Thyroid Nodules on Imaging? An Approach for the RadiologistJenny K. Hoang, Phillip Raduazo, David M. Yousem, James D. Eastwood10.1053/j.sult.2011.12.004Seminars in Ultrasound, CT and MRI 33, 2 (2012)2012-04-01Seminars in Ultrasound, CT and MRI2012-04-01332S0887-2171(11)X0008-2150157http://www.semultrasoundctmri.com/article/PIIS0887217111001648/abstract?rss=yes Thyroid nodules are a common clinical problem and are noted much more commonly on imaging examinations than are apparent by palpation. Fine-needle aspiration biopsy (FNA), which yields a cytology specimen for analysis, is the standard test to determine whether surgical removal of a detected nodule is recommended. This article will review the current guidelines for recommending FNA of thyroid nodules, the technique and risk of the procedure, and the implications for patient care based on FNA results. FNA has an essential role in the evaluation of patients with thyroid nodules to reduce the rate of unnecessary thyroid surgery for patients with benign nodules and triage patients with thyroid cancer to appropriate surgery. Before the routine use of FNA, approximately 14% of resected thyroid nodules were malignant, whereas with the current widespread use of thyroid nodule FNA, >50% of resected thyroid nodules are malignant.1 Historically, thyroid nodules were identified by physical examination of the neck, with a prevalence of approximately 5%-10% of adults in the United States, and these patients underwent palpation-guided FNA in the physician's office. In recent years, the increased use of sonography to examine the thyroid as well as cross-sectional imaging of the neck by computed tomography and magnetic resonance imaging has resulted in the detection of many nonpalpable nodules. In older adults, thyroid nodules may be detected in >67% of people screened by sonography.2 Fortunately, the vast majority of nodules are benign, but when they are discovered, an assessment regarding the need to exclude malignancy using FNA must be performed. Thyroid Nodule Fine-Needle AspirationJill E. Langer, Zubair W. Baloch, Cindy McGrath, Laurie A. Loevner, Susan J. Mandel10.1053/j.sult.2011.12.002Seminars in Ultrasound, CT and MRI 33, 2 (2012)2012-04-01Seminars in Ultrasound, CT and MRI2012-04-01332S0887-2171(11)X0008-2158165