Ultrasound effectiveness

[catlady55]

Dr. Lupo:
Can an ultrasound clearly determine if a suspicious nodule (which I have) is (1) encapsulated (I think that's the term), (2) if the lymph nodes are enlarged or note and (3) if there are nodules in the other lobe.
Can a surgeon determine this during surgery?
I've been reading about the stages of thyroid cancers and it seems that a partial thyroidectomy is acceptable to some doctors if you're in stage one.
I'm still trying to make sense of having a recommended TT if there's only a 20% chance of cancer, that thyroid cancer is fairly benign, slow growing, "best" cancer to have, etc etc.
Also, what is the best thyroid blood work to have prior to a TT? I would think it would be helpful to know exactly what my detailed levels are so we can try to  match them after the surgery?
Lastly, is it easier to manage thyroid blood levels if a patient has had a TT or is it eaier w/ patients who still have all or part of their thyroid?
Surgery is 9/25 and the surgeon says that a TT vs partial is my decision.
BTW....I've sent my slides and ultrasound DVD's to Dr Massol at U of F. Hopefully I have her second opinion next week.
Thanks again for participating in this forum
Catlady55

Thankhs for your help.

[Mark Lupo, M.D.]

would do a thyroglobulin panel before surgery in the event this is cancer -- to see how much the tumor makes Tg.....

[Mark Lupo, M.D.]

Ultrasound (in proper hands) is a useful guide but cannot document capsular invasion.  Lymph nodes can be assessed fairly well with ultrasound and at surgery.  Nodules in the other lobe should be visible on ultrasound (usually 2mm and larger, but at least 5mm and larger can be seen).

If the lesion is a true follicular lesion then it's 20% chance cancer and there is no test other than surgery to make the diagnosis.  If there is not any significant nodules on the other side, then usually a partial is our first choice.