Role of Preoperative Staging with Diagnostic Imaging and Laboratory Tests (1)

Recommendation no.ATA guidance
32APreoperative neck ultrasound for cervical (central and especially lateral neck compartments) lymph nodes is recommended for all patients undergoing thyroidectomy for malignant or suspicious for malignancy cytologic or molecular findings. (Strong recommendation, Moderate quality evidence)
32BUltrasound guided fine-needle aspiration of sonographically suspicious lymph nodes ≥ 8-10 mm in the smallest diameter should be performed to confirm malignancy if this would change management. (Strong recommendation, Moderate quality evidence)
32CThe addition of fine-needle aspiration thyroglobulin washout in the evaluation of suspicious cervical lymph nodes is appropriate in selected patients, but interpretation may be difficult in patients with an intact thyroid gland. (Week recommendation, Low quality evidence)
33APreoperative use of cross-sectional imaging studies (CT, MRI) with intravenous contrast is recommended as an adjunct to ultrasound for patients with clinical suspicion for advanced disease, including invasive primary tumor, or clinically apparent multiple or bulky lymph node involvement. (Strong recommendation, Low quality evidence)
33BRoutine preoperative 18 FDG-PET scanning is not recommended. (Strong recommendation, Low quality evidence)