Advancements in imaging
Novel ultrasound techniques may prove useful in the future for both the
diagnosis and follow-up of children with thyroid cancer but are not
currently standard of care. Ultrasound elastography is a non-invasive
method to evaluate the stiffness of tissue. Its use has been studied in
adults and shown to increase the sensitivity and negative predictive
value in the assessment of thyroid nodules for
malignancy.44 Ultrasound elastography may also be
useful in the future to help distinguish benign from malignant cervical
lymph nodes.45 However, further study is needed in
children.25
Contrast-enhanced ultrasound (CEUS) is another newer ultrasound
technique that uses the IV administration of an ultrasound contrast
agent to assess enhancement features. CEUS has been shown to increase
the accuracy of thyroid nodule diagnosis in adults, particularly when
combined with grayscale ultrasound features.46,47Confirmatory studies of its utility in children with thyroid nodules are
needed.