THYROIDSCAN 101: The Evolution of a National Diagnostic Movement

Launching THYROIDSCAN WEST: A New Era in Thyroid Diagnostics

By Dr. Leslie Valle Montoya

The thyroid gland is a small but powerful regulator of metabolism, energy, and hormonal balance—yet its disorders are notoriously underdiagnosed or misinterpreted. With the launch of THYROIDSCAN WEST, my mission is to change that narrative by offering cutting-edge, in-office thyroid imaging that delivers precision, clarity, and confidence in patient care.

This initiative is inspired by two remarkable leaders in thyroid health and diagnostics: Dr. Robert Bard, a globally recognized authority on advanced ultrasound imaging, and Dr. Angela Mazza, whose ThyroidTalk platform continues to educate the world on integrative endocrinology. Together, their expertise has driven my dedication to creating an accessible, technology-powered approach to thyroid screening and metabolic health assessment.

The Terason 3200T Advantage

At the heart of this initiative is the Terason 3200T ultrasound system, an advanced, portable platform specifically designed for high-resolution soft tissue imaging. Unlike standard ultrasound units, the 3200T provides exceptional detail for superficial structures like the thyroid gland, enabling early detection of abnormalities that might otherwise be missed.

Key features include:

• High-Frequency Linear Probe (12–15 MHz): Enables clear visualization of nodules as small as 2–3 mm.

• Doppler Blood Flow Imaging: Detects abnormal vascular activity associated with inflammation or malignancy risk.

• Elastography Capabilities: Assesses tissue stiffness to help differentiate benign from suspicious nodules.

• Dynamic Real-Time Imaging: Complements lab hormone values with live visual data on gland function.

• Digital Archiving: Allows longitudinal tracking of gland changes and treatment progress.

TeleMedScans™: Expert Eyes on Every Image- Nationwide!

An exciting aspect of THYROIDSCAN WEST is the ability to collaborate directly with Dr. Robert Bard—regardless of geography—through his proprietary TeleMedScans™ platform. This secure, remote interpretation service enables me to transmit high-quality thyroid ultrasound images directly to Dr. Bard’s diagnostic center.

Leveraging his decades of expertise in ultrasound interpretation, Dr. Bard can review and provide a specialist-level second opinion within hours. This collaboration ensures that complex or borderline findings receive the highest level of diagnostic scrutiny, enhancing decision-making for follow-up care, biopsies, or advanced treatment planning.

This seamless integration of real-time imaging technology and expert telemedicine consultation brings patients unprecedented access to top-tier thyroid diagnostics—without leaving the clinic.

THYROIDSCAN WEST represents the future of thyroid care: preventive, precise, collaborative, and patient-centered. (stay tuned for updates in THYROIDSCAN.ORG) 

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A Review on Patients Who Benefit from Imaging

Written By: Dr. Robert L. Bard

Introduction

Advancements in diagnostic imaging have transformed the way clinicians approach complex, multisystem diseases, especially those with subtle or overlapping symptoms. This review presents a case study highlighting the integrative role of advanced imaging modalities in detecting and managing thyroid abnormalities and associated cardiovascular conditions in a perimenopausal patient. A female in her late 40’s with borderline laboratory results, unexplained weight gain, and elevated blood pressure serves as the clinical focus for this comprehensive diagnostic workup.

The initial thyroid sonogram, a cornerstone in endocrine evaluation, identified abnormalities requiring further functional and structural imaging. Technologies such as Doppler imaging, 3D volume histogram analysis, elastography, and spectroscopy were employed to define tissue characteristics, vascular flow, and fibrotic changes. Concurrently, thermology and microvascular mapping revealed evidence of cardiovascular involvement, prompting a broader physiologic assessment.

The article further discusses the emerging connection between endocrine and cardiovascular dysfunctions in perimenopausal women, exploring the diagnostic potential of non-invasive thermal imaging and AI-enhanced technologies. It also emphasizes the value of integrative, real-time imaging techniques in differentiating inflammation from malignancy and guiding therapeutic decisions. These evolving modalities represent the future of personalized, precision medicine in diagnosing and managing chronic inflammatory, vascular, and oncologic diseases.

Routine thyroid sonograms begin with bilateral transverse and longitudinal views. If abnormalities are detected, additional modalities such as functional Doppler imaging, 3D volume histogram, M-mode tissue signature scan, 405nm spectroscopy, microvascular mapping, thermology, and elastography may be employed.

[Fig. 1] - In the transverse scan of the left thyroid gland, the initial contact echoes originate from the dermis (moderately echogenic), followed by subcutaneous tissue (echo poor), and linear fascial tissue overlying the deeper muscle layer. The trachea (with two cartilage rings), thyroid gland, and cross-section of the common carotid artery are labeled. The upper lobe demonstrates an echo-poor medial pattern, while the lateral segment retains a normal, moderately echogenic texture.

Due to multiple abnormalities, advanced diagnostic imaging was utilized:

• Functional Doppler imaging revealed decreased blood flow in both lobes.

• 3D volume histogram mapped the extent of fibrotic regions.

• M-mode tissue signature scan quantified poor sound penetration due to scarring.

• 405nm spectroscopy ruled out bacterial disease.

• Microvascular mapping provided a treatment guide.

• Thermology with strain elastography outlined the borders of poorly functioning tissue.

• Shear wave elastography (SWE) quantified the degree of fibrosis, aiding therapeutic planning.

CARDIOVASCULAR SYSTEM ASSESSMENT
As evidence of cardiovascular involvement emerged, further evaluation with thermologic modalities was pursued. Thermology is a non-invasive physiologic and biologic assessment of the cardiovascular system, employing autonomic stress to provoke functional changes — much like a stress test. Hemodynamic challenges are visualized, guiding the physician to identify the most vulnerable anatomic areas.

The value of this technology in cardiovascular screening was noted serendipitously during breast cancer investigations, where abnormal carotid artery circulation in the neck was detected. Similarly, while scanning facial skin for psoriasis and rosacea, notable differences in post-stress physiologic blood flow images were observed. Concussion patients also demonstrated functional distortions in orbital circulation symmetry, correlating with increased intracranial pressure from slowly developing post-traumatic subdural hematomas.

Detecting Perimenopausal Cardiovascular Disease (CVD)
While reviewing the medical history from an anomalous breast examination, a connection to underlying cardiac dysfunction was uncovered. In Europe, MRI elastography has, for the past six years, identified post-viral myocarditis and post-vaccine cardiac reactions.

While chronic heart failure in women is reliably diagnosed through echocardiography and EKG, the subtle, silent nature of early arterial stenosis and cardiomyopathy presents a clinical dilemma — one that may be addressed with AI-enhanced thermal screening technologies.

The Future
The development of a non-invasive, cost-effective, and quantitative tool for CVD screening holds promise. Conditions such as endometriosis, inflammatory diseases (like psoriasis), and arteritis may benefit from ultrasound elastography’s capacity to detect vascular inflammation.

Therapeutic Advances
Emerging strategies now combine thermal imaging, epigenetic analysis, and microvascular/photoacoustic ultrasound — a diagnostic platform capable of differentiating malignancies from inflammation, while quantitatively assessing metastatic potential in real time. This capability allows for on-the-spot evaluation of treatment efficacy. This innovation is particularly impactful in melanoma care, where aggressive tumors are highly vascular and thermally active. Intriguingly, successfully treated tumors may enlarge as they necrose — a feature now trackable through these technologies. Such advancements are expected to expand into managing diseases like psoriasis, endometriosis, thyroiditis, lupus, and Lyme disease, alongside non-surgical bioenergy therapies.

Conclusion
This case study underscores the vital role of advanced, multimodal imaging in the early detection and management of complex, multisystem conditions, particularly in perimenopausal women who often present with subtle or atypical clinical findings. Through the integration of conventional ultrasound with advanced technologies such as Doppler imaging, 3D volume histograms, M-mode tissue analysis, spectroscopy, elastography, and thermology, a comprehensive diagnostic picture was established. These imaging modalities not only identified structural thyroid abnormalities but also revealed functional vascular impairments and early cardiovascular involvement.

The findings highlight the evolving connection between endocrine dysfunction, inflammatory disease, and cardiovascular risk in midlife women — a demographic often underrepresented in cardiovascular research. Additionally, the potential of AI-enhanced thermal imaging and photoacoustic ultrasound to distinguish inflammation from malignancy and to quantify metastatic activity in real time represents a significant advancement in personalized medicine.

As diagnostic imaging continues to evolve, integrating physiologic, metabolic, and structural assessments will enable earlier detection, more precise characterization of disease processes, and the ability to monitor treatment efficacy non-invasively. This multidisciplinary, technology-driven approach promises to improve outcomes not only in oncology but also in chronic inflammatory and vascular diseases that remain challenging to detect in their earliest stages.

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Reference

Landi A, Bard R. (1974). Takayasu’s Arteritis. NYS J Med. 109:22-28.

Revolutionizing Parathyroid Imaging:

Dr. Robert Bard’s Pioneering Ultrasound Protocol for Precision Endocrine Diagnostics

Introduction: Rethinking Parathyroid Assessment

For decades, the diagnostic gold standard for parathyroid adenomas has been technetium-99m sestamibi scintigraphy—a nuclear medicine technique boasting a reported accuracy of approximately 95% in experienced centers. However, its dependence on radioactive isotopes and its limited capacity for precise anatomical localization have motivated researchers to seek alternatives. Dr. Robert L. Bard, a leader in advanced ultrasound imaging, has introduced a breakthrough protocol that leverages high-frequency ultrasound and 3D Doppler technologies for non-invasive parathyroid evaluation. His methodology offers not only diagnostic accuracy but also a path to image-guided interventions that may transform the treatment landscape.

 

The Clinical Spark: A Case Study in Innovation

The foundation of Bard’s protocol emerged five years ago with a patient suspected of harboring a parathyroid adenoma. While sestamibi (MIBI) scans remain highly accurate, they involve intravenous radioactive tracers, raising patient concerns about radiation exposure. Recognizing this gap, Bard applied his expertise in high-resolution ultrasound—tools honed for skin cancer and thyroid pathology—to the parathyroid region.

Utilizing a linear array transducer operating at 18–24 MHz, Bard and his team identified a distinct, hypoechoic, homogeneous, egg-shaped mass measuring 9 × 6 mm adjacent to the thyroid capsule. This lesion exhibited smooth margins and was clearly extrathyroidal in position—a key feature distinguishing parathyroid adenomas from thyroid nodules.

“Parathyroid lesions are highly vascular, which is why they fluoresce on isotope scans,” Bard explains. “When we activated power Doppler, the adenoma lit up like a beacon.” This vascular signature provided a second layer of confirmation and set the stage for precise surgical planning. The lesion was successfully resected within days.

Interestingly, this patient’s serum calcium was only borderline elevated—highlighting another clinical pearl. “Population-based reference ranges can miss subtle dysregulations,” Bard observes. “What’s ‘normal’ for one demographic may be pathologic for another, especially considering geographic, ethnic, and immunologic factors.”

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Technical Insights: Probe Selection and Imaging Techniques

High-resolution ultrasound of the parathyroid requires technical expertise and the appropriate equipment. Dr. Bard recommends the following parameters for endocrinologists integrating this modality into their practice:

·        Probe Type: Linear array transducers with frequencies of 18–25 MHz are optimal for their superior resolution of superficial structures. For patients with a thick neck or deep-seated glands (e.g., in the mediastinum), a convex probe (5–9 MHz) may be necessary.

·        Patient Positioning: The patient is placed supine with the neck extended to expose the anterior cervical region. A pillow under the shoulders facilitates extension and reduces shadowing.

·        Scanning Planes: Both transverse and longitudinal planes are essential. Bard emphasizes a meticulous survey of the thyroid’s periphery, as 80–90% of adenomas lie adjacent to the thyroid capsule.

·        Microvascular Imaging (MVI) Doppler: Power Doppler or color Doppler should be routinely employed. Parathyroid adenomas exhibit a hypervascular “spoke-wheel” or peripheral arc pattern that differentiates them from lymph nodes or cysts.

·        3D Imaging: Dr. Bard integrates volumetric 3D ultrasound for precise localization and mapping of lesion vascularity. This modality provides data sets for potential image-guided interventions.

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Comparing Ultrasound and Sestamibi Scintigraphy

While sestamibi scans remain a mainstay, they are not without limitations:

 

Parameter	Sestamibi Scan	High-Resolution Ultrasound
Radiation Exposure	Yes (Technetium-99m)	None
Resolution of Small Lesions	Limited (<5 mm often missed)	Excellent (lesions as small as 3 mm detectable)
Functional Information	Provides functional uptake data	Provides vascularity and structural detail
Cost	Higher (nuclear medicine suite required)	Lower (standard ultrasound setup)
Real-Time Imaging	No	Yes (dynamic and Doppler assessment)

Bard highlights that in experienced hands, ultrasound can rival or even surpass sestamibi imaging for certain patients, particularly when combined with biochemical markers and clinical suspicion.

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Expanding the Scope: 3D Doppler for Monitoring and Intervention

Beyond detection, 3D Doppler imaging offers a dynamic tool for monitoring lesion activity and guiding therapy. Bard draws parallels from his extensive experience in prostate cancer management, where MRI-ultrasound fusion and 3D imaging facilitate targeted therapies.

“Just as we use real-time imaging to guide laser ablation in prostate and thyroid tumors, the same principles apply to parathyroid lesions,” Bard asserts. The superficial location of most parathyroid adenomas makes them ideal candidates for focal therapies, including:

·        Radiofrequency Ablation (RFA)

·        Laser Interstitial Thermal Therapy (LITT)

·        Cryoablation

·        High-Intensity Focused Ultrasound (HIFU)

These techniques, currently experimental for parathyroid disease, hold promise for patients who are poor surgical candidates or those with recurrent disease after initial parathyroidectomy.

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Public Awareness and Broader Screening

An anecdote from Bard’s breast imaging practice underscores the broader implications of this technology. After distributing flyers about parathyroid screening, a male patient—originally accompanying his partner—recognized his own symptoms and was subsequently diagnosed with an active adenoma. This case highlights the need for awareness across genders and suggests that family members of affected patients could benefit from non-invasive ultrasound screening.

 

Conclusion: Toward a New Standard in Parathyroid Imaging

Dr. Robert Bard’s pioneering work with high-resolution ultrasound and 3D Doppler imaging represents a paradigm shift in endocrine diagnostics. By eliminating radiation, enhancing resolution, and enabling real-time assessment, this approach aligns with precision medicine’s goals of safety, efficacy, and patient-centered care.

For endocrinologists seeking to expand their diagnostic armamentarium, integrating advanced ultrasound techniques offers a viable and highly effective alternative to traditional nuclear imaging. As Bard’s experience demonstrates, this technology not only enhances detection but also opens new avenues for minimally invasive therapies—heralding a future where parathyroid disease is managed with greater precision and compassion.