Thyroid cancer, as one of the most common endocrine cancers, has seen a surge in incidence in recent years. This is most likely due to the lack of specificity and accuracy of its traditional diagnostic modalities, leading to the overdiagnosis of thyroid nodules. Although there are several treatment options available, they are limited to surgery and 131I radiation therapy that come with significant side effects and hence cannot meet the treatment needs of anaplastic thyroid carcinoma with very high malignancy. Optical imaging that utilizes optical absorption, refraction and scattering properties, not only observes the structure and function of cells, tissues, organs, or even the whole organism to assist in diagnosis, but can also be used to perform optical therapy to achieve targeted non-invasive and precise treatment of thyroid cancer. These applications of screening, diagnosis, and treatment, lend to optical imaging\'s promising potential within the realm of thyroid cancer surgical navigation. Over the past decade, research on optical imaging in the diagnosis and treatment of thyroid cancer has been growing year by year, but no comprehensive review on this topic has been published. Here, we review key advances in the application of optical imaging in the diagnosis and treatment of thyroid cancer and discuss the challenges and potential for clinical translation of this technology.

We describe an 81-year-old man with end-stage renal disease and central venous occlusion who was referred for dialysis access creation. This case illustrates a novel percutaneous image fusion-guided recanalization of an occluded right subclavian vein and brachiocephalic vein stent in a patient with limited remaining dialysis access sites. (Level of Difficulty: Advanced.).

Iatrogenic cardiac perforation is a major complication of cardiac intervention. Surgical correction of perforation is standard of care. We discuss a pacing wire induced right ventricular perforation during the coronavirus disease-2019 (COVID-19) pandemic. Open heart surgery was high risk due to age and COVID-related significant lung involvement. As a bailout measure, the perforation was successfully closed with transcatheter intervention. (Level of Difficulty: Advanced.).

Superior vena cava syndrome (SVCS) is traditionally associated with malignancy. However, approximately one-third of SVCS cases are due to intravascular devices and pacemakers. No specific guidelines exist for managing catheter-associated SVCS. We present catheter-associated SVCS resistant to anticoagulation, angioplasty, and thrombectomy but resolved with ultrasound-assisted catheter directed thrombolysis. (Level of Difficulty: Intermediate.).

Balloon- or plug-assisted retrograde transvenous obliteration of portosystemic shunts is an effective endovascular technique for the treatment of type B bypass hepatic encephalopathy. We describe a patient who underwent balloon- and plug-assisted obliteration for a lienorenal and lienogonadal shunt, respectively. He returned with symptoms of recurrent hepatic encephalopathy two years later due to reformation of new lienorenal and lienogonadal shunts. Repeat obliteration of these new shunts was now performed using balloon and coil assistance. We describe the treatment for multiple portosystemic shunts with combined usage of vascular plug, balloon and coils depending on anatomical and technically factors. Our case also highlights that after shunt obliteration increased portal pressure may form new portosystemic collateral pathways which leads to clinical failure and may require repeat treatment.

OBJECTIVE: To determine the role of Contrast enhanced MRI (CEMRI) in the evaluation of Cavernous sinus thrombosis (CST).
METHODS: The study included 7 patients with an imaging diagnosis of cavernous sinus thrombosis. A retrospective analysis of Contrast enhanced MRI of 9 affected cavernous sinuses and a control group of 7 patients (14 cavernous sinuses) was conducted. Various qualitative and quantitative parameters were then compared.
RESULTS: In the patient group, the mean Cavernous sinus (CS) diameter, Cavernous Internal Carotid Artery (ICA) diameter and Superior Ophthalmic Vein (SOV) diameter were 9.14 ± 0.56 mm, 3.5 mm ± 0.9 mm and 3.8 mm ± 1.79 mm respectively. While in the control group, the mean CS diameter, ICA diameter and SOV dimeter were 6.58 ± 0.54 mm, 4.6 mm ± 0.44 mm and 1.1 mm ± 0.11 mm respectively. The differences in the CS size, ICA and SOV diameters was statistically significant. (p < 0.05). Cut off points of ≥ 10 mm for CS diameter, ≥ 2.9 mm for SOV dilation, and ≤ 4.2 mm for ICA flow void diameter were estimated using receiver operating characteristic curves. Various other qualitative parameters, like bulging lateral walls of the sinus, heterogenous signal intensity with filling defects on post contrast images, abnormal dural enhancement along the lateral wall of the sinus and orbital apex involvement were more frequently observed in the CST group, in comparison to the control group.
CONCLUSIONS: CEMRI plays an invaluable role not only in the diagnosis of cavernous sinus thrombosis, but also in evaluating the extent of disease and its associated complications. The quantitative and qualitative parameters described here, provide more objectivity and accuracy in diagnosis of CST, thus, aiding prompt diagnosis and early treatment.

Tumor thrombosis of the internal jugular vein (IJV) represents an uncommon event, usually in the setting of underlying thyroid neoplasms. Extraosseous plasmacytoma (EMP) with tumor thrombosis of the IJV has not yet been reported in the literature. We present a unique case of a plasmacytoma in the left parapharyngeal space with direct extension to the left IJV, documented with contrast enhanced computed tomography and US Doppler. Presence of avid thrombus enhancement allowed differentiation between tumoral extension and thrombothic changes.

We report a case of vascular malformation arising from internal jugular vein discovered during radiological investigations for restaging of metastatic colon carcinoma of an adult male patient. Congenital absence of internal jugular vein is extremely uncommon. These developmental anomalies in general population are seen in about 0.05%-0.25%. The awareness of these vascular anomalies is extremely important to avoid unsafe complications, primarily in oncological patients, whom usually require the incannulation of neck veins for diagnostic procedures or intravenous therapy administration.

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