Korean J Endocr Surg.  2011 Jun;11(2):81-85. 10.0000/kjes.2011.11.2.81.

The Clinical Significance of Scored CT Findings for Pre-operative Prediction of Lateral Cervical Lymph Node Metastasis in Thyroid Cancer

• Kim YJ
• Kim JY
• Kim YS
• Lee KJ
• Lee DH
• Bae JS
• Sung KY
• Kim JS
• Park WC

• KMID: 2375370
• DOI: http://doi.org/10.0000/kjes.2011.11.2.81

Abstract

PURPOSE
Although ultrasound is routinely used for pre-operative evaluation of neck nodes in patients with papillary thyroid carcinoma, CT is also widely used. We designed a prediction score of lateral cervical lymph node metastasis (PSLCNM) for improving diagnostic ability of CT. The purpose of our study was to determine the clinical significance of the PSLCNM.
METHODS
A total of 124 patients with thyroid carcinoma who underwent surgery of lateral cervical lymph node dissection after pre-operative CT evaluation were enrolled in this study. We retrospectively evaluated the diagnostic ability between CT findings by one radiologist and PSLCNM for prediction of lateral lymph node metastasis.
RESULTS
In terms of predicting lateral cervical node metastasis, the positive predictive value of CT findings of indeterminate, suspicious, or metastatic nodes were 37.5% (21/56), 68.3% (28/41), 85.7% (18/21). Those of 1, 2, 3, 4 in sum of PSLCNM were 34% (16/47), 60% (30/50), 91% (10/11), 100% (10/10).
CONCLUSION
Prediction of lateral cervical node metastasis using PSLCNM showed a better result than conventional CT findings and could decrease unnecessary surgical procedures and postoperative complications in the surgery of thyroid cancer.

Keyword

Thyroid cancer; Lateral cervical lymph node metastasis; Positive predictive value; Computed tomography

MeSH Terms

Humans
Lymph Node Excision
Lymph Nodes*
Neck
Neoplasm Metastasis*
Postoperative Complications
Retrospective Studies
Thyroid Gland*
Thyroid Neoplasms*
Ultrasonography