Thyroid function tests (TFTs): this test checks the level of thyroid hormones in the blood. It is usually requested whenever someone first presents to their doctor with a thyroid swelling. It is a helpful test to see if the thyroid gland is working normally. This test is usually normal if thyroid cancer is present.
Fine needle aspiration cytology (FNAC)
This involves a small needle being inserted through the skin into the thyroid gland lump or into lymph glands/nodes in the neck to remove some cells. This can either be done in the routine clinic or may be done with the help of an ultrasound scan.
Sometimes a FNAC result will not be helpful and a core biopsy or very occasionally a surgical biopsy may be needed. If this is needed the doctor would explain in more detail what it would entail and whether any anaesthetic is required.
Thyroid Ultrasound scan (USS)
This test uses gel and a probe rubbed over the neck to look at the size and texture of the thyroid gland and the lymph glands/nodes in the neck. It can show if there are any lumps in the thyroid gland, if the lumps are solid or fluid containing and if the lymph glands/nodes look normal in shape and size. If anything shows up it is possible to use the ultrasound probe and pictures to guide the needle used for a FNA (see above).
CT (Computerised Tomography) or MRI (Magnetic Resonance Imaging)
These 2 types of scan show a 3 dimensional picture of the inside of the body. They are not always required but can be helpful to show if the cancer is growing outside of the thyroid gland and can provide more information on the lymph glands/nodes and other parts of the body such as the lungs, liver and bones.
Thyroid radionucleotide or radioisotope scans
This test is no longer commonly done. It involves an injection of a small amount of radioactive liquid (either iodine or technetium) into an arm vein followed by a scan about 20 minutes later. The scan pictures are taken using a gamma camera x ray machine which is positioned over the neck area.
PET (Positron Emission Tomography) scan
This is another type of radioactive scan. It is not so widely available in the UK as the other types of scan discussed above. It is rarely needed at the time of thyroid cancer diagnosis but might be useful during the follow up period of a small number of patients when other x ray tests have not been helpful.
This is used to describe the size of the thyroid cancer and whether it has spread outside the thyroid gland to involve the lymph glands/nodes or other parts of the body.
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Thyroid Cancer Forum UKDr. Kate Garcez
Christie NHS Foundation Trust, Manchester, M20 4BX
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