Efficacy of preoperative neck ultrasound in the detection of cervical lymph node metastasis from thyroid cancer

Authors

  • Harry S. Hwang MD,

    1. Department of Otolaryngology–Head and Neck Surgery, University of California, San Francisco, San Francisco, California, U.S.A.
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    • Dr. Hwang received a CTSI Resident Research Travel Award from the University of California, San Francisco, to present this research study at the Annual Triological Society Meeting. The authors have no other funding, financial relationships, or conflicts of interest to disclose.

  • Lisa A. Orloff MD

    Corresponding author
    1. Department of Otolaryngology–Head and Neck Surgery, University of California, San Francisco, San Francisco, California, U.S.A.
    • University of California, San Francisco, Department of Otolaryngology–Head and Neck Surgery, Box 1703, 2380 Sutter Street, 2nd Floor, San Francisco, CA 94115
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  • Presented at the Triological Society 113th Annual Meeting, Las Vegas, Nevada, U.S.A., April 30–May 1, 2010.

Abstract

Objectives/Hypothesis:

This study was performed to assess the diagnostic accuracy of surgeon-performed preoperative neck ultrasound (US) in the detection of both central and lateral cervical lymph node metastases from thyroid cancer.

Study Design:

Prospective cohort study.

Methods:

Data for all patients with thyroid cancers and follicular thyroid lesions who were evaluated by means of preoperative neck US were reviewed. The cervical lymph nodes were assessed for suspicion of metastasis based on US characteristics. The diagnostic accuracy of US was determined according to whether histologically confirmed cancer was present in surgical cervical lymph node specimens.

Results:

The sensitivity and specificity of US in predicting papillary thyroid carcinoma (PTC) metastasis in the central neck were 30.0% and 86.8%, respectively. The sensitivity and specificity of US in predicting metastasis in the lateral neck were 93.8% and 80.0%, respectively. A subset of patients underwent US followed by revision neck dissection for PTC, and the sensitivity and specificity of US in predicting metastasis in the lateral neck were 100% and 100%, respectively.

Conclusions:

Preoperative neck US is a valuable tool in assessing patients with thyroid cancers. The highly sensitive and specific nature of US in predicting cervical lymph node metastasis in the lateral neck, especially in the setting of recurrent disease, can provide reliable information to assist in surgical management. Although US for central compartment lymphadenopathy in the presence of the thyroid gland is less sensitive and specific than US for the lateral neck, it still provides useful information that can be obtained at the same time the primary thyroid pathology is assessed. Laryngoscope, 2011

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