Postoperative staging and long-term surveillance

After surgical resection, disease is staged based on the operative findings to identify patients with persistent disease and those at intermediate or high risk of recurrence. Initial staging should be performed within 12 weeks after surgery to assess for evidence of persistent locoregional disease and to identify patients who are likely to benefit from additional therapy with 131I. The ATA pediatric risk level helps determine the extent of postoperative testing.[9] The standard imaging study for the follow-up of patients who have been treated for differentiated thyroid carcinoma is neck ultrasonography. It should be performed by a professional with experience using this procedure in children. The sensitivity and specificity of neck ultrasonography for recurrent differentiated thyroid carcinoma in follow-up for children who have been treated with total thyroidectomy are 85.7% and 89.4%, respectively.[6]