The Significance of Carrying out a Thyroid Ultrasound - Term Paper Example

Thyroid ultrasound Name: Institution: Thyroid ultrasound Literature Review Definition of important terms Thyroid is also scientifically referred to as the thyroid gland. Thyroid gland is located in the neck region of a normal human being. The thyroid gland is very important in the body as it is responsible for controlling normal metabolic activities like protein synthesis and production of certain body hormones. Like other body tissues, thyroid gland is prone to malfunctioning scientifically referred to as cancers. Cancer is the uncontrolled multiplication of body cells. Individuals suffering from cancer of the thyroid usually have large body mass in the neck region which in most patients is painless. To identify the cancers, an ultrasound procedure needs to be performed. An ultrasound is usually a painless scientific procedure. An ultrasound procedure makes use of sound waves to make images of the inside of the body. The mass growth at the neck region is usually caused by thyroid nodules that usually arise in an otherwise, normal thyroid gland. The nodules are scientifically known to cause thyroid neoplasm. Not all of the thyroid nodules are used to indicate thyroid gland cancers. Some of the nodules do occur as a result of normal growth and are there to maintain normal flow of activities in the thyroid gland. But other modules usually do happen as a result of abnormal growth that occurs most of the times at the edge of the thyroid gland in the neck region. The abnormal nodules are usually cavities filled with a fluid referred to as thyroid cyst. Thyroid cyst mostly contains harmless particles but on other occasions it may contain harmful and malignant solid particles. The significance of carrying out a thyroid ultrasound is to identify and differentiate benign tumours from malignant ones. Benign and malignant thyroid nodules As already discussed in the above introduction, not all nodules in the neck region are harmful. The nodules are usually visible from the outside with normal human eyes. In a thin individual, the nodules are usually more visible. A larger percentage of the nodules formed at the neck region are usually harmless. Only less than four percent of the nodules can be found to malignant. Many factors and symptoms are usually considered when determining malignant nodules in the thyroid. Previous patients who have been diagnosed with malignant tumours have usually expressed certain symptoms. Symptoms expressed include; troubles swallowing solid food, characteristic swollen lymph nodes, some patients usually find it hard speaking while others have immovable nodules that are hard in nature (Luo, Kim, Dighe & Kim, 2011). Some nodules may be as a result of autoimmune disorders such as goitre while other nodules may be painful but they are harmless. The prevalence of malignant tumours is high in male than female individuals and also in people who have a family history of thyroid cancer. Use of ultrasound in determining malignant and benign nodules Several studies have been carried out to determine the difference between harmful and harmless thyroid nodules. Both nodules occur at the same location with almost similar physical properties. To determine the difference between the two nodules a closer examination requires to be done. The use of an ultrasound technique has proven to be more reliable in the determination of malignant and non-malignant nodules. Ultrasound as highlighted above in the text uses sound wavelength to create images of the tissue in study. Ultrasound waves are powerful and effective in determining the small and minor differences between the nodules (Sebag et al, 2010). In the process of imaging, ultrasound waves are used to determine the position, magnitude, roughness or smoothness of the nodule and whether the nodules are dry or filled with some fluids (Shi, Li, Shi, Liu,Ding & Qin, 2012). Some of the nodules identified through ultrasound may be fluid filled. It is therefore hard to determine the extent of malignancy through viewing the ultrasound images. A further clinical step requires to be performed. The procedure that is performed next is referred to as fine needle aspiration biopsy. The fluid contents in the nodules are extracted and then examined by a pathologist. The examination is usually performed to determine whether the nodule is malignant or benign (Maia et al, 2011). As the name suggests, fine needle biopsy is usually performed using a needle to withdraw the contents within the cyst. Determining whether a nodule is malignant or harmless is a very important step in the treatment of cancerous nodules of the thyroid gland. Wrong lab results may lead to wrong diagnosis thus imposing more danger to an individual’s health. The risk factors of an individual having thyroid nodules ranges from sex, gender to the family’s history of exposure to radiotherapy. The application of ultrasound imaging in the field has on the positive side yielded more information on this relevant topic. Fine needle aspiration biopsy has been studied to be more accurate and very fast (Cantisani et al, 2012). The use of ultrasound sonography in combination with fine needle aspiration biopsy is effective but the process is long and tiresome. Controversy on thyroid nodule evaluation Various articles in the past have reviewed the controversy surrounding the evaluation of thyroid nodules to determine whether they are malignant or harmless. The process of ultrasound is usually painless which therefore indicates that the controversy does not originate from that particular area. From the analysis of the previous articles, the source of controversy usually arises from the fact the use of ultrasound cannot fully determine whether the nodules identified are malignant or benign. Through the use of ultrasound, the position size, and the surface nature of the nodules can only be identified. Ultrasound can also identify nodules filled with fluids and those that are dry. The determination of benign and malignant nodules for the nodules filled with fluids requires a further step which is fine needle biopsy (Abele, 2013). Fine needle biopsy is also a painless process that is done through injecting the subjects with needles in their neck regions to obtain the fluid extract (Young, Lumapas-Gonzalez & Mirasol, 2014). It is the fluid extract that is examined to determine the malignancy of the nodules. Despite the controversy associated with the long process in the evaluation of malignant tumours, fine needle biopsy has proven to be more effective in the identification of malignant tumours at the time of surgery. However, the application of fine needle biopsy on more than one occasion can result in failing to obtain a sufficiently fine specimen. When unclear specimen is collected from the patients, wrong diagnosis can be carried out (Nou, Kwong, Alexander, Cibas, Marqusee & Alexander, 2013). When the detection procedures fail to clearly determine which nodules are malignant, the management process of particular patients becomes a harder task to accomplish. It becomes a hard task because of the fact that some of the nodules may be follicular neoplasms which are wrongly diagnosed as malignant nodules. It is however important to note that fifteen to twenty percent of the neoplasm lessons on most individuals have been found to be malignant. When ultrasound and fine needle aspiration biopsy have failed to detect malignant from benign tumours, a surgery is the next step in diagnosing the severity of the nodules. A surgery is very expensive but most likely to yield true positive results. Therefore, it is important to answer the following question; is ultrasound an important procedure in detection of nonpalpable and malignant nodules? Different researchers in the field may answer the question differently depending on the criteria they are using. As already indicated in various scientific articles, the use of ultrasound solely cannot fully differentiate malignant from benign nodules. It is through the intervention of fine needle aspiration biopsy that the suspiciously malignant nodules are identified from the benign ones (Kamran et al2012). After the identification process is when the preventive measures like surgery are taken to minimize the risks of the identified nodules. The answer to the question mentioned above is that it is not easy to abolish thyroid ultrasound in the detection of thyroid nodules. It is a procedure that is performed routinely by most practitioners. The fact that it cannot provide full results at once is the subject that yields a lot of heated debate over its application. To minimize the procedure in determining suspicious nodules, the application of ultrasound should not be used occasionally. Established practitioners who are full aware of the merits of ultrasound should also not rely on the use of ultrasound only without the support of other established methods like fine needle aspiration biopsy (Kennedy, Breen, O’Regan, McCarthy, Horgan & Henry, 2012). Comparison between ultrasound and fine needle aspiration biopsy Both methods are effective in the evaluation of nodules of the thyroid gland. Ultrasound method has currently become like a mandatory procedure in the determination of the nodules. Ultrasound is first performed in majority of the patients as the first diagnostic procedure. It is has proven to be good as ultrasound studies the size and other observable physical qualities to determine which nodules are malignant and which nodules are benign (Alexander & Cooper, 2013). Fine needle biopsy is on most occasions applied as the interventional procedure where the doctors want to be sure with the diagnostic results. Fine needle aspiration biopsy on most occasions usually correctly determines which nodules are malignant and which ones are benign (Heller, Gilbert, Ohori, & Tublin, 2013). However, on fewer occasions the fine needle aspiration biopsy may give false results. Despite the ups and downs of using the fine needle biopsy, it is safe and minimal level of complications (Samir et al, 2012). On a clinical level, it is of great significance to combine both of the two methods to fully determine and differentiate between benign and suspicious nodules. However, on an advisory note, the use of only fine needle aspiration biopsy can reduce the long procedure that is currently being performed in most of the hospitals (Abele, 2013). Significance of thyroid ultrasound The wide spread use of ultrasound in the detection of thyroid nodules has played a significant role in the management of thyroid related complications. The clinical application of ultrasound has led to an increased rate of detecting nonpalpable nodules. The management of benign nodules has become a relatively simple step from the result of using ultrasound. It is a cheap and relatively very fast in detecting thyroid nodules. Through the use of thyroid ultrasound, small micro nodules can be detected as early as possible and dealt with effectively (Alexander & Cooper, 2013). The use of thyroid ultrasound imaging techniques has replaced the primitive surgical techniques that were performed blindly. The diagnosis of carcinomas related to the thyroid region has since then increased from the time ultrasound imaging technique came in to use (Brito et al, 2013). Initial methods of thyroid nodule detection to the current techniques in use and any future prospects Initially, several mechanisms were employed from the diagnosis and management of thyroid nodules. Apart from the blind surgical procedures that were used in the management of the nodules, serum evaluation technique was used as a preferred method of diagnosis. Thyroid stimulating hormone was the compound that was being evaluated in the serum samples. However, the analysis of patient’s serum is still of great importance up to today in detecting cancers associated with thyroid. This is simply because the current ultrasound techniques in use are not able to detect cancerous nodules. The application of ultrasound sonography is advisable for patients with low risk. Various advancements are currently being made in the field of imaging concerning the detection of thyroid nodule. Radionuclide imaging has been in use for a period of time but has been currently advanced to detect thyroid related complications (Moon et al, 2011). Positron emission tomography is the new radionuclide technique that is being advanced to ease on the detection thyroid nodules (Nikiforov, Yip & Nikiforova, 2013). Ultrasound electrograph is specialized in the measurement of tissue elasticity and can effectively differentiate between benign and malignant nodules (Bhatia et al, 2011). Recommendations Since thyroid ultrasound has become such an interesting and a controversial topic, major advancements are required to focus on the current issues at hand. The issues include the ability of the imaging to identify between malignant and benign nodules without the performance of other procedures. The advanced ultrasound techniques should be able to identify major carcinomas associated with occurrence of thyroid nodules (Paschke, Hegedüs, Alexander, Valcavi, Papini & Gharib, 2011). Conclusion Thyroid ultrasound is an important area in the management of carcinomas related to the thyroid nodule. Various advancements have already been made in the field. Controversies concerning the use of ultrasound have already been highlighted in the text above. The major area of concern is the ability of thyroid ultrasound to determine fully which nodules are malignant and which ones are benign. However, current advancements and new imaging techniques are making sure that the concerns raised are fully covered. References Abele, J. S. (2013). Thyroid Ultrasound-Guided Fine-Needle Aspiration: A Case Report Emphasizing the Sonographic Features of Benign Versus Malignant Thyroid Nodules. Pathology Case Reviews, 18(1), 25-27. Abele, J. S. (2013). 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