Real-Time Neck Ultrasound

REAL-TIME NECK ULTRASOUND  -  GETTYSBURG, PA

REAL-TIME NECK ULTRASOUND WITH POWER DOPPLER

Diagnostic Ultrasound: Ultrasound utilizes harmless sound waves to produce images of the thyroid. Ultrasound exams are done in “real-time” by Dr. Michael during an office visit. The procedure is simple and painless. The patient lies flat with the neck slightly extended, transducer gel is placed on the neck and the ultrasound probe is moved over the gland and surrounding lymph nodes. By having an expert in thyroid ultrasound perform your thyroid images you will receive immediate results, a plan on how to treat your thyroid condition and biopsy if necessary.
  1. Pre-operative Lymph node mapping
  2. Post-operative Thyroid cancer follow-up lymph node mapping
  3. Parathyroid adenomas

ULTRASOUND-GUIDED ULTRASOUND FNA

FNA (fine needle aspiration): To better assess a thyroid nodule, a biopsy is often necessary. A fine-needle aspiration biopsy (FNA) uses a small needle (smaller than most blood draw needles) to obtain cell samples from the thyroid nodule. The standard of care (best practice) is to perform this function under ultrasound guidance (using the ultrasound to determine exactly where the needle is going), This ensures that the needle tip is within the targeted nodule at the time of aspiration. Dr. Michael has performed thousands of these procedures with insufficient results in less than 1% of samples on solid nodules. 
 
Local anesthesia is offered but not always necessary as the discomfort is similar to a blood draw. The risks are minimal, including minor bruising or discomfort no special preparation is needed. (no fasting). Patients usually return home or to work after the biopsy.
  1. Cysts
  2. Cancer: suspicious lymph nodes with cancer marker washings for:
    1. Thyroglobulin
    2. Calcitonin
    3. RPMI Flow cytometry for lymphoma
  3. Suspect parathyroid adenoma with PTH washings

ULTRASOUND-GUIDED THERAPEUTIC INTERVENTIONS

Percutaneous Ethanol Injection: This painless injection of alcohol into thyroid cysts has been a successful alternative to prevent the recurrence of thyroid cysts and an alternative to surgery for recurrent cysts.
 
Alcohol injections have also been used as an alternative to surgery for recurrent cancer established in Lymph Nodes in the Neck. The method is effective in killing nodes with cancer and preventing continued growth. The cancer marker thyroglobulin drops after the injection and is used in patients where surgery is too dangerous or neck re-operation is not desired.
 
Dr. Michael uses ultrasound-guided ethanol injections (PEI), to treat thyroid nodules that are cystic, eliminating the need for surgery. PEI can also be used to eliminate malignant lymph nodes in patients when surgery is undesired.
 
Lymph node mapping pre-operatively for your surgeon, Unfortunately, many patients in the U.S. undergo thyroid cancer surgery without Preoperative Ultrasound Mapping and, in about 15% of cases, this results in leaving behind lymph nodes (LN) to which the cancer has already spread. These cancers are then “discovered” years later during cancer follow-up exams and usually require additional surgery. Pre-operative lymph node mapping will identify lymph nodes that can be biopsied to confirm metastasis which will extend the surgery to include removal of involved lymph nodes and increase the chance of cure and decrease your chance of recurrence. The goal is to make the initial surgery the only surgery patients will need. Having to go back into a previously operated neck (for persistent disease, LN left behind) increases the risks of recurrent laryngeal nerve damage and hypoparathyroidism.
 
Pre-operative Ultrasound Mapping is performed for all patients undergoing surgery for suspected thyroid cancer. This method improves the care of the thyroid cancer patient through a team approach between the thyroid specialist and the surgeon to give you the best possible outcome. A map is drawn for the surgeon to guide the extent of surgery. 
 
Post-operative ultrasound surveillance in patients who have undergone thyroid surgery for cancer is performed routinely to monitor for the development of lymphatic spread of the cancer as this is the most common pattern of recurrence.
  1. Percutaneous Ethanol Injections PEI for thyroid and parathyroid cysts
  2. PEI for thyroid cancer lymph node ablation
Have questions that we didn't answer here? 
Schedule a Consultation Today
Share by: