THE ESSENTIALS OF THYROID IMAGING (Extra: Thyroid CancerScanning)

By: Dr. Robert Bard

When imaging detects a suspicious area, it can guide selective biopsies to obtain small tissue samples for further laboratory analysis (pathology). Combining imaging with pathology provides the most accurate information about the size, location, and aggressiveness of any issue detected.  In the case of thyroid imaging, use of an ultrasound uses sound waves to create images of the thyroid gland in the neck. It is often used for this organ because it is a non-invasive procedure that does not use ionizing radiation. It’s commonly used to evaluate lumps or nodules detected during a physical exam or other imaging tests and requires minimal preparation.

 Thyroid nodule (tumor) - doppler ultrasound

The ultrasound helps doctors visualize the thyroid's size, shape, and potential abnormalities like nodules, cysts, or inflammation, aiding in diagnosis and treatment planning. It’s typically performed when physical exams show:

 - A growth on the thyroid, known as a thyroid nodule (image - R).

- An enlarged or irregular thyroid (goiter).

- Abnormal lymph nodes near the thyroid.

THE ROLE OF THE THYROID GLAND: The thyroid is a butterfly-shaped organ in the endocrine system that regulates hormones influencing various bodily functions. These hormones affect both physical and mental performance, so unexplained symptoms may indicate a thyroid issue.

HYPERTHYROIDISM AND THYROID DISORDERS: Thyroid disorders can stem from various causes and affect the balance of hormones in the body. A range of treatments is available for managing thyroid issues, from medication to non-invasive procedures.

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Part2: 3-25-2025

THYROID HEALTH: WHY ULTRASOUND MATTERS

By: Dr. Leslie Valle-Montoya

Have you ever had your thyroid checked? If not, now is the time! While standard thyroid function tests measure hormone levels in the blood to detect disorders like hypothyroidism (underactive thyroid) and hyperthyroidism (overactive thyroid), they don’t tell the whole story. That’s where modern ultrasound technology steps in.

Unlike blood tests, which focus on hormone production, ultrasound provides a real-time, detailed view of the thyroid gland itself. This imaging technique uses sound waves to assess the gland’s size, shape, and structure—offering insights that hormone tests simply can’t provide.

Advanced ultrasound methods, such as 3D Doppler Blood Flow and Elastography, enhance diagnostic accuracy by measuring blood flow and tissue stiffness. These features help differentiate between benign and potentially malignant nodules, offering a clearer picture of thyroid health. By identifying whether nodules are solid or fluid-filled, ultrasound aids in assessing cancer risk and guiding further evaluation.

If you've never had a thyroid ultrasound, consider it an essential step in understanding your thyroid health beyond just hormone levels. A complete evaluation means looking at both function and structure—because when it comes to your health, knowledge is power.

Prologue:

LEARNING FROM THE ULTRASOUND GURU - DAY ONE!

Since COVID, I’ve connected with countless health professionals over Zoom. Even today, virtual meetings remain the norm for work engagements, often replacing in-person visits and hands-on collaborations.

But today, we broke that mold. I had the privilege of finally meeting Dr. Robert Bard in person—a true pioneer in diagnostic imaging! After five years of remote referrals, I traveled from Santa Barbara, CA, to New York City for a firsthand look at his cutting-edge arsenal of medical technology. More than just a tour, I also received an intensive crash course in ultrasound operation. Dr. Bard had previously mailed me a hospital-grade Terason T-3200 for my practice, and now, under his guidance, I was able to put it to use.

This marks the beginning of our TelemedScan remote overreading collaboration, and learning from "The Cancer Detective" himself was an incredible honor—an opportunity few get to experience from the front row.

"The best way to learn ultrasound is to be a patient," Dr. Bard explained. "Its real-time scanning ability lets you see as you scan—the screen tells all, right on the spot!"

With that in mind, we decided to scan my thyroid, a first for me. Given our collaboration on a perimenopause project, I knew it was time to practice what I’m about to preach. Having access to one of the best thyroid imaging experts in the field was an unexpected luxury—one I wasn’t about to pass up. During the session, I was introduced to the concept of sonology—where the radiologist directly controls the probe, eliminating the middle step of a technician. This hands-on approach allows for immediate interpretation, deeper exploration, and a more interactive learning experience between doctor and patient.

TBC

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Part3:

THYROID CANCER:
Thyroid tumors are common but can be hard to diagnose by touch alone. Sonography is the primary method for detecting and monitoring suspicious nodules. Areas with calcium deposits are especially concerning and often require biopsy under ultrasound guidance. Parathyroid masses, which can cause significant health issues like bone loss in women or kidney stones in men, may also be detected. Ultrasound can also identify cancer spread to nearby lymph nodes, which can be biopsied with imaging guidance.

THYROID CANCER FAQ's

Q: Why is a sonogram important if I visit my doctor annually?
Blood tests often miss thyroid tumors, which can be difficult to detect through physical examination, especially if they are deep within the gland.

Q: What happens if a tumor is found?
Many benign conditions, like cysts, can be differentiated from cancer without a biopsy. Ultrasound can assess calcium content, which may indicate cancer, requiring further tests.

Q: Does every suspicious area require a biopsy?
Ultrasound screening and other tests can reduce unnecessary biopsies. Small suspicious areas are typically monitored for growth every 3-6 months before considering a biopsy.

Q: How far can thyroid cancer spread?
Most thyroid cancers grow slowly and spread locally. Metastasis is rare and can be evaluated using MRI scans.

Q: Can ultrasound detect parathyroid tumors that cause osteoporosis?
Parathyroid adenomas are typically benign but can lead to significant physical effects due to hormonal imbalances. These tumors can often be diagnosed with 3-D Power Doppler Histogram .

In summary, ultrasound imaging plays a crucial role in evaluating thyroid health by providing a safe, non-invasive, and highly detailed view of the gland. When combined with pathology, it enhances diagnostic accuracy, guiding appropriate treatment decisions. This synergy between imaging and laboratory analysis ensures a comprehensive approach to identifying and managing thyroid conditions effectively.

 

ABOUT THE AUTHOR-

ROBERT L. BARD, MD, PC, DABR, FASLMS - Advanced Imaging & Diagnostic Specialist

Having paved the way for the study of various cancers both clinically and academically, Dr. Robert Bard co-founded the 9/11 CancerScan program to bring additional diagnostic support to all first responders from Ground Zero. His main practice in midtown, NYC (Bard Diagnostic Imaging- www.CancerScan.com) uses the latest in digital Imaging technology has been also used to help guide biopsies and in many cases, even replicate much of the same reports of a clinical invasive biopsy. Imaging solutions such as high-powered Sonograms, Spectral Doppler, sonofluoroscopy, 3D/4D Image Reconstruction and the Spectral Doppler are safe, noninvasive, and does not use ionizing radiation. It is used as a complement to find anomalies and help diagnose the causes of pain, swelling and infection in the body’s internal organs while allowing the diagnostician the ability to zoom and ‘travel’ deep into the body for maximum exploration.