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What Can a Thyroid MRI Help With? Plus Other Thyroid Evaluations

Key takeaways:

  • It’s impossible to tell whether a thyroid nodule or goiter is benign without further testing like ultrasound and biopsy.
  • Thyroid MRI can help stage thyroid cancer, look for metastasis (spreading to other organs), and monitor nodules. 
  • Thyroid MRI may help determine whether you have Hashimoto’s thyroiditis versus Grave’s disease.
  • Ezra Full Body and Full Body Plus scans include a snapshot of the thyroid, which can help healthcare professionals develop a baseline understanding of the organ’s health.

MRI, or magnetic resonance imaging, is a radiology scan that produces detailed images of your body’s organs and soft tissues.

A thyroid MRI focuses on the thyroid gland, which is located in the lower part of your neck.

Because of their proximity, an MRI of the thyroid may also spot changes or abnormalities in the throat, neck, and (importantly) the parathyroid glands. MRI can also help oncologists understand your thyroid cancer better.

Can a Thyroid MRI Screen for Cancer?

The only way to tell if a lesion is thyroid cancer or not is through a fine needle aspiration biopsy. However, a radiology imaging modality like MRI is an important tool for evaluating known cancer, seeing if it has spread, and watching for recurrence.

The main role for MRI in thyroid cancer is to help your oncology team stage the cancer. MRI may also help doctors find out if the cancer has spread to the lymph nodes or to other organs.

Finally, thyroid MRI aids in the management of thyroid nodules and monitoring for recurring cancer after a thyroidectomy (surgery to remove the thyroid).

A screening MRI like ezra’s Full Body and Full Body Plus isn’t designed to diagnose thyroid cancer. However, it can provide a snapshot or a baseline image of your thyroid.

If something abnormal is spotted, you’ll be able to follow-up with your primary care provider or endocrinologist for further testing. 

Other Radiology Tests for Thyroid Cancer

Tests that examine the neck and surrounding tissues are helpful in the diagnosis and management of thyroid cancer, including:

  • High-resolution ultrasound is the first imaging method used in evaluating thyroid nodules for potential malignancy. It also helps to guide fine needle aspiration biopsies of suspected lesions. Oncologists and radiologists may use a system called TIRADS (Thyroid Imaging Reporting and Data Systems) to help determine which nodes to biopsy.
  • Doppler ultrasound helps distinguish healthy lymph nodes from those with focal hyperperfusion, a key finding in malignancy.
  • Contrast-enhanced thyroid sonography may help radiologists to view the parathyroid glands better than other methods. 
  • Thyroid scans are radioiodine imaging procedures. Before this test, you’ll swallow a small amount of radioactive material. After it is absorbed by the thyroid gland, a special camera will measure the amount of radioactivity. Cold areas are less active and more likely to be cancerous nodes. Hot areas are less likely to have cancer cells.
  • PET scan may be useful if it’s suspected you have a type of cancer that doesn’t show up on radioiodine testing. It is also helpful to find out if cancer has spread.
  • Thyroid CT scan is a test that uses X-rays to compile detailed images of the body. It can help spot a lesion that has microcalcifications and help healthcare professionals determine the size and location. 

What Are Your Thyroid and Parathyroid Glands?

Glands are important organs in your endocrine system. Located all over your body, glands perform specific jobs, like creating and releasing hormones. 

The thyroid is a two-lobed, butterfly-shaped glandular organ on the anterior or front side of your neck. It extends from the fifth cervical vertebrae to the first thoracic vertebrae.

Your thyroid makes and secretes several hormones that work together to help your body use energy and regulate your metabolism.

The parathyroid comprises four pebble-sized glands found in pairs behind each lobe of the thyroid. These tiny glands regulate the balance of calcium in your body. Calcium regulation ensures your bones, kidneys, heart, nerves, and blood vessels work properly. 

What Is Parathyroid Dysfunction?

Considering that the parathyroid regulates calcium, it isn’t surprising that some of the most common signs and symptoms of parathyroid dysfunction mimic calcium mineral imbalance.

Symptoms can include:

  • Osteoporosis (porous or weak bones), bone wasting, bone pain, and broken bones
  • Muscle weakness
  • Tiredness
  • Thirst
  • Frequent urination
  • Kidney stones

Types of Thyroid Cancer

According to the American Thyroid Association, there are several types of thyroid cancer.

Papillary and follicular thyroid cancers, called well-differentiated thyroid cancer, are among the most common and have the best outcomes.

Differentiation means that the cancer cells look similar to thyroid cells under cytology (microscopic examination).

  • Papillary thyroid carcinoma type makes up 70% to 80% of all thyroid cancer cases. This cancer type can occur at any age, though it grows slowly and is associated with a high five-year survival rate.
  • Follicular thyroid cancer is less common, occurring in about 10% to 15% of all thyroid cancer cases. It is less likely to spread to lymph nodes but more likely to spread to other organs (metastasis).
  • Anaplastic or undifferentiated is the most aggressive type of thyroid cancer. It is rare, accounting for 1% to 2% of all thyroid cancer cases. These cells do not resemble thyroid cells during cytology interpretation.
  • Medullary thyroid cancer (MTC) also occurs about 1% to 2% of the time. It has a different point of origin and has symptoms that often resemble parathyroid disease due to its effect on the production of the hormone calcitonin. 

Signs and Symptoms of Thyroid Disease

Thyroid MRI: smiling woman

A normal thyroid gland is smooth, with soft, fleshy, and symmetrical lobes. Your thyroid shouldn’t be tender or sore. It’s normal for it to move upward slightly when you swallow. 

You can have a normal thyroid upon physical examination and still experience thyroid dysfunction like hypothyroidism and hyperthyroidism.

While MRI doesn’t play a role in diagnosing these dysfunctions, the symptoms involved with them are often the first signs of thyroid disease.

1. Hypothyroid Dysfunction

Hypothyroid dysfunction occurs when your thyroid isn’t creating and releasing enough thyroid hormones into your bloodstream.

Thyroid function blood tests often reveal an underactive thyroid. Common symptoms of hypothyroid dysfunction include:

  • Slow metabolism
  • Constipation
  • Weight gain
  • Slow heart rate
  • Tiredness
  • Low body temperature
  • Oily skin
  • Fertility problems

2. Hyperthyroidism

Hyperthyroidism happens when the thyroid is overactive. You can be diagnosed through thyroid function studies and clinical symptoms that could include:

  • Unexplained weight loss
  • Rapid heart rate
  • Brittle hair
  • Hair loss
  • Dry skin
  • Bulging eyes
  • Swollen neck

3. Hashimoto’s Thyroiditis

Hashimoto’s Thyroiditis is an inflamed thyroid gland caused by an autoimmune reaction. It may also be called chronic lymphocytic thyroiditis.

You may experience hyperthyroid symptoms followed by hypothyroid symptoms years later. MRI may be helpful in distinguishing Hashimoto’s from Grave’s Disease (an immune disease that causes an overproduction of thyroid hormone. 

4. Benign Thyroid Nodules, Goiter, and Lesions

A few of the symptoms that may accompany thyroid growths include trouble swallowing, difficulty breathing, hoarseness, pain, cough, and vascular pulsation (feeling your heartbeat in the front of your lower neck). 

Thyroid nodules or lumps are the most common abnormalities. The incidence of nodules large enough to feel upon exam is 6.4% in women and 1.5% in men, according to some studies.

Other retrospective studies have put the incidence of thyroid nodules at between 37% and 57%. Without further testing, there is no way to tell if nodular thyroid disease is a non-cancerous adenoma or something more serious.

Goiter, or an enlarged thyroid gland, refers to a lesion that may be caused by a lack of dietary iodine, imbalance of thyroid hormones, or autoimmune conditions like Grave’s disease. Goiter may also be caused by thyroid malignancy. 

Get a Snapshot of Your Thyroid With an ezra Scan

A focused thyroid MRI is a great way to evaluate potential cancer in the thyroid gland.

Oncologists use the information from MRIs and other radiology exams to identify nodules, guide biopsy, stage thyroid cancer, and monitor for recurrence after surgery.

A thyroid MRI may also be helpful in distinguishing between thyroid disorders like Hashimoto’s thyroiditis and Grave’s Disease. 

But you don’t have to have cancer or thyroid symptoms to get a snapshot of your thyroid gland.

To stay proactive about your health, ezra offers whole-body MRIs that screen up to 13 organs, including the thyroid, for early diseases and abnormalities.

The entire scan usually takes less than an hour. An ezra clinician will follow up in about a week with your results over a telehealth call. 

Get started today by creating an account and scheduling your full-body MRI scan with ezra. Book a scan now.