The Role of Ultrasound in Evaluating Thyroid Nodules

by | Jan 30, 2024

Your thyroid is an important part of your body, governing its functions in multiple areas. Thyroid nodules are a very common issue, and are mostly benign, but a very small number can be cancerous. Because of this, it is recommended to get thyroid nodules checked to see if anything needs to be done.

Asian patient undergoing ultrasound of thyroid nodules and gland

Introduction to Thyroids

Thyroid nodules are small lumps that develop on your thyroid gland. The vast majority are benign and don’t require any treatment. It is a very common condition seen in approximately 30% of adults and more commonly seen in females. People with Hashimoto’s thyroiditis, a common cause of hypothyroidism, are at higher risk of developing nodules. Iodine deficiency can also cause nodules, but is rare in Singapore. The vast majority of nodules have no known cause.

In most cases, thyroid nodules cause no symptoms and are found incidentally in a physical exam or sometimes by the patient when tightening a collar or fastening a necklace. In some cases, nodules may produce more hormones, leading to hyperthyroidism. Rarely, nodules may grow large enough to cause pain in the ear, jaw, or neck, impact the windpipe or esophagus, or cause hoarseness. But for the vast majority of patients, the only symptom is the lump itself, which can go unnoticed. Treatment, in these cases, consists of monitoring to ensure the nodule does not grow. However, for cancerous nodules, surgical removal is recommended. Surgery may also be recommended for nodules causing pain or other symptoms. 

The Function of the Thyroid Gland

Do you have problems swallowing or other warning signs? When a thyroid nodule is discovered, it needs to be evaluated. The key initial tool is ultrasound imaging. It is fast, accurate, and non-invasive. Ultrasound imaging is used for initial evaluation, and can determine things like:

  • Whether the nodule is solid or a fluid-filled cyst
  • The precise size and location of the nodule
  • How suspicious a nodule is based on whether it shares features with cancerous nodules
  • Locate mass structures in the thyroid gland
  • See whether the tumor is inside or outside the thyroid gland
  • Evaluate adjacent structures of the thyroid gland
  • Determine causes of hyperthyroidism or hypothyroidism
  • Assess complications post neck surgery
  • Preliminary classification of thyroid nodule in the case of multinodular goiter

Ultrasound can also find nodules that are too small to be noticed during a physical examination. When assessing adjacent structures, the doctor can tell if a larger nodule is starting to impinge on the windpipe, esophagus, or nerves in the throat. This is an indication that surgery may be warranted. Using vascular ultrasound helps assess this and also look at blood flow to the lump.

People with thyroid nodules may be referred for imaging at regular intervals to monitor the nodule and make sure it is not becoming cancerous.


Can Ultrasound Detect Thyroid Cancer?

On its own, no. Ultrasound can, however, determine which nodules are more likely to be cancerous. If the nodule looks suspicious on ultrasound, you will be referred for a fine needle aspiration biopsy (FNAC). This is a procedure in which a small needle is inserted into the thyroid gland to withdraw cells from the nodule. These cells are then examined under a microscope to look for cancerous changes.

FNAC is an outpatient procedure typically done in a doctor’s office and most people don’t even need a local anesthetic or a band-aid. However, ultrasound ensures procedures are not done unnecessarily and also provides the image the doctor needs to insert the needle accurately. Biopsies are typically reported as benign (80%), cancerous (5%) or indeterminate. If cancer is found, surgical removal of the thyroid is recommended, but thyroid cancer is seldom fatal. For some indeterminate results, part of the thyroid is removed. Cysts often have to be reevaluated after biopsy, but a good ultrasound tech can identify cysts at that stage.
So, ultrasound cannot detect thyroid cancer on its own, but is a key part of the diagnosis.

To protect your thyroid health and make informed decisions when it comes to treating these lumps and preventing cancerous nodules, find out more on our blog post, “Types of Thyroid Nodules and Cancer”.

Blood Tests for Thyroid Nodules

A thyroid ultrasound is fast and painless. We recommend that you leave neck jewelry at home, as you will be asked to remove it. You should wear loose, comfortable clothing, but don’t have to do any prep. You will lie on an exam table with a pillow behind your shoulders. A thyroid nodule specialist and expert radiologist in Singapore like Dr. Manish Taneja will apply a water-based gel to your neck and then a transducer will be placed on your neck and moved. Most people feel nothing, but you may feel a tiny bit of pressure or very minor pain. Afterwards, the gel will be wiped off. The procedure takes less than 30 minutes in most cases. You will have no downtime afterwards; you can schedule it during your lunch break if you need to. 

Based on the findings, you may be recommended for FNCA or for a repeat ultrasound in six months or a year. Although most thyroid nodules aren’t cancerous, early treatment of the few that are is important and typically results in a good prognosis. Surgery may not be necessary in most cases unless the nodule is cancerous. If you have large benign nodules, your doctor may use radiofrequency ablation as a minimally invasive treatment option. Read more on our blog post about “RFA, the Latest Minimally Invasive Treatment for Thyroid Nodules.”  

World Class Care for Thyroid Nodules Treatment in Singapore

If you have a thyroid nodule or any thyroid gland-related concerns, Dr. Manish Taneja of Supreme Vascular and Interventional Clinic in Singapore prioritizes your thyroid health and will recommended an ultrasound. Don’t let your nodules impact your functions and lifestyle. An expert radiologist can evaluate the nodule properly, answer your questions, and reduce your worries. A thyroid nodule ultrasound scan will help him make the right recommendations. Contact Supreme Vascular to schedule an appointment today.

    Thyroid Nodule Radiofrequency Ablation (RFA) Treatment

    Radiofrequency ablation aims to give patients a non-surgical option for treating thyroid nodules. This procedure is a minimally invasive option that a surgeon can perform, should the preliminary tests determine that you would benefit from it.

    The Advantages of RFA of Thyroid Nodules

    The major advantages of the technique are as below.

    1. It is done as day surgery procedure under light sedation.
    2. It takes about 45 minutes to one hour to complete the entire procedure.
    3. Patients are discharged the same day.
    4. Normal thyroid tissue adjacent to the nodule is preserved.
    5. It does not affect thyroid function.
    6. Multiple nodules can be treated at same time.
    7. The treated nodules do not regrow again.
    8. No surgical scar with needle mark on the skin.
    9. Quick recovery and back to full activity and normal lifestyle.
    10. The technique is suitable to treat even large thyroid nodules.

    Find out how thyroid nodule Radiofrequency Ablation can help you in a minimally invasive way on our blog post, “Thyroid Nodule Radiofrequency Ablation Treatment: Diagnosis,  Management, and Recovery.”

    Find the Right Doctor

    From family and internal medicine to specialist, Dr. Manish Taneja is the best in the field.

    As a vascular and interventional radiology specialist, Dr Manish Taneja looks after peripheral vascular disease, aneurysms, dialysis interventions, venous diseases like deep vein thrombosis, and varicose veins/spider veins/reticular veins. He is also competent in performing newer endovascular procedures such as uterine artery embolization, prostate artery embolization, genicular artery embolization, and erectile dysfunction interventions.

    Dr. Manish Taneja also has extensive experience in performing all vascular interventions, non-vascular interventions and interventional oncology procedures.

    Read More About Vascular Treatments on Our Blog

    To dive deeper into the types of vascular treatments such as thyroid nodule radiofrequency ablation, head over to our clinic’s blog.  Read our recommended vascular treatments related blog posts to stay informed.

    Thyroid Nodule Resources

    How to Keep Thyroid Healthy for Optimal Well-Being

    As part of the endocrine system, the thyroid hormones must be perfectly balanced at all times for the body to function normally.

    Woman holding and using megaphone

    Caring For Your Thyroid Health

    Have you ever experienced difficulty swallowing or breathing? You may have risk factors including a family history of thyroid nodules or iodine deficiency. Thyroid nodules are abnormal lumps (growths) within the thyroid gland, a butterfly-shaped gland located below your voice box. Even if most thyroid nodules are benign, 10-15% of nodules are cancerous. Sometimes overgrowth of normal thyroid tissue can lead to hyperthyroidism. In other cases, multiple nodules can form in the thyroid called multinodular goiter. Fluid filled thyroid cysts can be one type of thyroid nodule within the thyroid. More complex nodules may lead to thyroid cancers.

    Depending on the root cause and type of nodule you have, patients can monitor with regular ultrasound or even have a thyroid fine needle aspiration biopsy (FNAC) if required. Surgery to remove partial or whole thyroid gland can be done but thanks to minimally invasive treatments such as Radiofrequency Ablation (RFA), this procedure can treat noncancerous and cancerous thyroid lumps.

    Types of Thyroid Nodules and Cancer

    Watch our video guide and find out more on our blog post, “Types of Thyroid Nodules and Cancer” with the types, causes, evaluation, biopsy, treatment options, and when to see a thyroid specialist. Find answers to questions on whether thyroid nodules are cancerous or not.

    Arrange Your Appointment

    Consult Vascular Specialist, Dr. Manish Taneja

    Other Health Conditions

    The Supreme Vascular and Interventional Clinic is your “go-to” facility for various conditions and pain management. To arrange an appointment with Dr. Manish Taneja, our thyroid nodule specialist, contact us. You can also call us at (+65) 6904 8084 for a consultation.