Ultrasonographic Surveillance Following Thyroidectomy for Differentiated Thyroid Cancer

Differentiated thyroid cancer, particularly papillary thyroid carcinoma, comprises the majority of thyroid malignancies and is typically associated with an indolent clinical course and favorable prognosis Nevertheless, locoregional recurrence occurs in approximately 10%–30% of cases, most commonly affecting the cervical lymph nodes and thyroid bed. Neck ultrasound (US) is a highly sensitive and widely employed modality for detecting recurrent lesions in central and lateral neck compartments. It is non-invasive, provides real-time imaging, and facilitates US-guided fine-needle aspiration (FNA) or surgical intervention. Despite its advantages, the diagnostic accuracy of US is limited by operator dependency and postoperative tissue changes or benign conditions that might resemble recurrence. Proficiency in neck US requires extensive experience and a comprehensive understanding of neck anatomy, lymph node compartments, and relevant differential diagnoses. While characteristic sonographic features aid in diagnosis, they must be interpreted alongside clinical and biochemical indicators, including serum thyroglobulin (Tg) levels and prior disease status. Accurate detection and appropriate management of recurrence depend on optimized US technique, standardized reporting, and the judicious use of adjunctive diagnostic tools, such as FNA and FNA-Tg.