Assessing thyroid perfusion

The following question has been sent by Han Dan, China:

Because the  thyroid gland is very sensitive to X-yay, we want to know if we could check the thyroid gland by CT perfusion or if we use lower dose in scanning when we check the thyroid gland by CT perfusion. Thank you very much.

Thomas Albrecht, M.D., Free University and Humboldt University of Berlin:

Dear Dr. Han Dan,

I would generally not use perfusion CT with multiple CT acquisitions for the thyroid gland because of its high sensitivity to radiation. If you have to use CT, it would be wise to use a low dose protocol. I have no experience with this in he neck, but I suggest that you test how low you can go (maybe reducing not only tube current but also tube potential to e.g. 80 kV) and still achieve acceptable image quality for your purposes in an elderly patient or a cancer patient with low life expectancy. Good alternative techniques for assessing thyroid perfusion might be contrast enhanced US or MRI.

I hope this is helpful. Best wishes
Th. Albrecht