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.