Ultrasound-based clinical prediction rule model for detecting papillary thyroid cancer in cervical lymph nodes: A pilot study

2015 ◽  
Vol 44 (3) ◽  
pp. 143-151 ◽  
Author(s):  
Nayana U. Patel ◽  
Kristin McKinney ◽  
Sarah M. Kreidler ◽  
Teresa M. Bieker ◽  
Paul Russ ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Pilot Study ◽  
Lymph Nodes ◽  
Papillary Thyroid Cancer ◽  
Prediction Rule ◽  
Clinical Prediction Rule ◽  
Papillary Thyroid ◽  
Clinical Prediction ◽  
Cervical Lymph Nodes ◽  
Rule Model

scholarly journals Thyroglobulin measurements in washout of fine needle aspirates in cervical lymph nodes for detection of papillary thyroid cancer metastases

2010 ◽  
Vol 54 (6) ◽  
pp. 550-554 ◽  
Author(s):  
André B. Zanella ◽  
Erika L. Souza Meyer ◽  
Letícia Balzan ◽  
Antônio C. Silva ◽  
Joíza Camargo ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Lymph Nodes ◽  
Papillary Thyroid Cancer ◽  
Needle Aspiration ◽  
Papillary Thyroid ◽  
Cervical Lymph Nodes ◽  
Fine Needle ◽  
Fine Needle Aspirates ◽  
Cancer Metastases ◽  
Thyroid Cancer Metastases

OBJECTIVE: The aim of this study was to evaluate the accuracy of the measurement of thyroglobulin in washout needle aspiration biopsy (FNAB-Tg) to detect papillary thyroid cancer (PTC) metastases. SUBJECTS AND METHODS: Forty-three patients (51.4 ± 14.6 years) with PTC diagnosis and evidence of enlarged cervical lymph nodes (LN) were included. An ultrasound-guided fine-needle aspiration of suspicious LN was performed, for both cytological examination and measurement of FNAB-Tg. RESULTS: The median values of FNAB-Tg in patients with metastatic LN (n = 5) was 3,419 ng/mL (11.1-25,538), while patients without LN metastasis (n = 38) showed levels of 3.7 ng/mL (0.8-7.4). Considering a 10 ng/mL cutoff value for FNAB-Tg, the sensitivity and specificity was 100%. There were no differences on the median of FNAB-Tg measurements between those on (TSH 0.07 mUI/mL) or off levothyroxine (TSH 97.4 mUI/mL) therapy (3.3 vs. 3.8 ng/mL, respectively; P = 0.2). CONCLUSION: The results show that evaluation of FNAB-Tg in cervical LN is a valuable diagnostic tool for PTC metastases that can be used independent of the thyroid status.

scholarly journals The association between tumor’s location and cervical lymph nodes metastasis in papillary thyroid cancer

Gland Surgery ◽  
2019 ◽  
Vol 8 (5) ◽  
pp. 557-568 ◽  
Author(s):  
Ting-Ting Zhang ◽  
Xiu-Zhu Qi ◽  
Jian-Ping Chen ◽  
Rong-Liang Shi ◽  
Shi-Shuai Wen ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Lymph Nodes ◽  
Papillary Thyroid Cancer ◽  
Papillary Thyroid ◽  
Cervical Lymph Nodes ◽  
Lymph Nodes Metastasis

scholarly journals Elastography as a Potential Modality for Screening Cervical Lymph Nodes in Patients with Papillary Thyroid Cancer: A Review of Literature

2018 ◽  
Vol 97 (1-2) ◽  
pp. 31-39 ◽  
Author(s):  
Robert Saadi ◽  
Salvatore LaRusso ◽  
Kanupriya Vijay ◽  
David Goldenberg
Keyword(s):  
Thyroid Cancer ◽  
Lymph Nodes ◽  
Papillary Thyroid Cancer ◽  
Clinical Utility ◽  
Lymph Node Involvement ◽  
Papillary Thyroid ◽  
Ultrasound Technique ◽  
Cervical Lymph Nodes ◽  
Specific Patient ◽  
Clinical Criteria

Papillary thyroid cancer often presents with cervical lymph node involvement and has a high incidence of recurrence, which requires routine follow-up with ultrasound imaging. Elastography is a novel ultrasound technique that has been demonstrated to be effective clinically in detecting tissue pathology in areas such as the liver and breast. Preliminary data suggest that it may be effective in screening tissues in the neck for malignancy, specifically cervical lymph nodes. However, diagnostic criteria and elastographic techniques vary significantly among the studies we have reviewed, which all tend to focus on populations of patients with many different types of primary malignancies. Further research is required on the feasibility of creating standardized and reproducible clinical criteria in a specific patient population. To study the clinical utility of elastography in cervical lymph nodes, patients with diagnosed papillary thyroid carcinoma may serve as an ideal population because of their need for ultrasound surveillance and the propensity of papillary thyroid cancer to metastasize to and recur in cervical lymph nodes. We will review the limitations, techniques, and reported clinical utility of elastography on cervical lymph nodes and its potential as a screening modality for papillary thyroid cancer.

scholarly journals Suspicious Cervical Lymph Nodes Detected after Thyroidectomy for Papillary Thyroid Cancer Usually Remain Stable Over Years in Properly Selected Patients

2012 ◽  
Vol 97 (8) ◽  
pp. 2706-2713 ◽  
Author(s):  
E. Robenshtok ◽  
S. Fish ◽  
A. Bach ◽  
Jose M. Domínguez ◽  
A. Shaha ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Lymph Nodes ◽  
Papillary Thyroid Cancer ◽  
Active Surveillance ◽  
Regional Recurrence ◽  
Lateral Neck ◽  
Papillary Thyroid ◽  
Cervical Lymph Nodes ◽  
Value Range ◽  
Almost All

Abstract Context: The risk of loco-regional recurrence in papillary thyroid cancer (PTC) patients ranges from 15–30%. However, the clinical significance of small-volume loco-regional recurrence detected by highly sensitive ultrasonography is unclear. Objective: Our objective was to describe the natural history of abnormal cervical lymph nodes (LN) diagnosed after initial treatment. Design: We conducted a retrospective cohort study. Patients: 166 PTC with patients who had at least one abnormal LN outside the thyroid be on ultrasound and selected for active surveillance were included. Main Outcome Measure: LN growth during a period of active surveillance was the primary outcome. Results: Most patients had classical PTC (85%) and an intermediate risk of recurrence (77%). The median LN size at the start of the observation period was 1.3 cm (range, 0.5–2.7 cm) in largest diameter, with all nodes having at least one abnormal sonographic characteristic (70% of patients had LN with at least two abnormal features). In almost all patients, the LN were in the lateral neck, primarily in levels 3 (43%) and 4 (58%). After a median follow-up of 3.5 yr, only 20% (33 of 166) grew at least 3 mm, 9% (15 of 166) grew at least 5 mm, and 14% (23 of 166) resolved. None of the clinical or sonographic features were predictive of LN growth (positive predictive value range = 0.21–0.57). There were no local complications (nerve damage or local invasion) related to the abnormal nodes and no disease-related mortality. Conclusions: Suspicious cervical LN in the lateral neck usually remain stable for long periods of time in properly selected PTC patients and can be safely followed with serial ultrasounds

scholarly journals Utility of Surgeon-Performed Ultrasound Assessment of the Lateral Neck for Metastatic Papillary Thyroid Cancer

2012 ◽  
Vol 2012 ◽  
pp. 1-4 ◽  
Author(s):  
Cortney Y. Lee ◽  
Samuel K. Snyder ◽  
Terry C. Lairmore ◽  
Sean C. Dupont ◽  
Daniel C. Jupiter
Keyword(s):  
Thyroid Cancer ◽  
Lymph Nodes ◽  
Papillary Thyroid Cancer ◽  
Metastatic Disease ◽  
Needle Aspiration ◽  
Lateral Neck ◽  
Papillary Thyroid ◽  
Imaging Studies ◽  
Cervical Lymph Nodes ◽  
Ultrasound Assessment

Ultrasound is the recommended staging modality for papillary thyroid cancer. Surgeons proficient in US assessment of the neck and experienced in the management of papillary thyroid cancer (PTC) appear uniquely qualified to assess the lateral cervical lymph nodes for metastatic disease. Of 310 patients treated for PTC between 2000 and 2008, 109 underwent surgeon-performed ultrasound (SUS) of the lateral neck preoperatively. Fine needle aspiration was performed on suspicious lateral lymph nodes. SUS findings were compared with FNA cytology and results of postoperative imaging studies. The sensitivity and negative predictive value of SUS were 88% and 97%, respectively. Four patients were found to have missed metastatic disease within 6 months. No patient underwent a nontherapeutic neck dissection. SUS combined with US-guided FNA of suspicious lymph nodes can accurately stage PTC to reliably direct surgical management.

scholarly journals LEVELS I–VII FOLLOWING THYROIDECTOMY FOR PAPILLARY THYROID CANCER

2020 ◽  
Vol 19 (5) ◽  
pp. 76-81
Author(s):  
V. S. Parshin ◽  
A. A. Veselova ◽  
V. S. Medvedev ◽  
S. A. Ivanov ◽  
A. D. Kaprin
Keyword(s):  
Thyroid Cancer ◽  
Lymph Node ◽  
Lymph Nodes ◽  
Papillary Thyroid Cancer ◽  
Lymph Node Metastases ◽  
Cervical Lymph Node ◽  
Papillary Thyroid ◽  
Cervical Lymph Nodes ◽  
Cervical Lymph Node Metastases ◽  
Node Metastases

Introduction. Cervical lymph node metastases can occur not only in patients when they are first diagnosed with papillary thyroid cancer but also in patients who have undergone thyroidectomy. Objective. The aim of this study was to assess the potential utility of neck ultrasound in diagnosing cervical lymph node metastases (levels I–VII) in patients who underwent surgical treatment for papillary thyroid cancer.Material and Methods. B-mode sonography of all nodal levels in the neck was performed using a linear array transducer in the frequency range of 7.5–13 MHz, power mapping and panoramic scan to locate regional lymph node metastases. All lymph nodes removed during reoperations were submitted for histological evaluation. Sonographic examinations of cervical lymph nodes of the levels I–VII were performed in 2875 patients who had undergone thyroidectomy in different regions of the Russian Federation. The patients were admitted to our clinic to receive radioactive iodine therapy. All neck levels were assessed by ultrasound.Results. Sonography revealed cervical lymph node metastases in 267 (9.2 %) of 2875 patients with papillary thyroid cancer who had undergone thyroidectomy. Nodal metastasis in level VI only occurred in 70 (2.4 %) patients, in levels II–III–IV only in 150 (5.21 %), in level VB only in 32 (1.11 %), and at the same time in level VI and in levels II–III–IV in 15 (0.52 %) patients. There were no metastases in levels I, VA, VII of the neck. Solitary metastases to all levels were found in 7.5 %, multiple metastases in 1.2 %, and conglomerates in 0.6 % of cases. Solitary metastases in level VI were noted in 56 (1.9 %), in levels II–III–IV in 125 (4.3 %), and in level VB in 29 (1.0 %) patients. Multiple metastases in level VI were detected in 11 (0.38 %), in levels II–III–IV in 21 (0.73 %), and in level VB in 3 (0.1 %) patients. Median metastasis size was 2.1 ± 1.6 cm.Conclusion. Post-thyroidectomy patients were found to have cervical lymph node metastases. Ultrasound scanning of the neck should be considered a key examination if there are cicatricial changes as it enables to identify metastasis and to determine its location. The maximal number of metastases was noted in levels II–III–IV. Cervical lymph node metastases occurred less frequently in the central level and level VB. The predominant metastatic pattern was solitary. There was an essential difference in metastatic spread to cervical lymph nodes between postthyroidectomy patients and patients who were first diagnosed with papillary thyroid cancer. 

scholarly journals Ultrasound diagnosis of cervical levels II–IV lymph node metastasis in patients with first diagnosed papillary thyroid cancer

2020 ◽  
Vol 9 (4) ◽  
pp. 17-23
Author(s):  
V. S. Parshin ◽  
A. A. Veselova ◽  
V. S. Medvedev ◽  
S. A. Ivanov ◽  
A. D. Kaprin
Keyword(s):  
Thyroid Cancer ◽  
Lymph Node ◽  
Lymph Nodes ◽  
Papillary Thyroid Cancer ◽  
Predictive Value ◽  
Imaging Method ◽  
Thyroid Tumors ◽  
Papillary Thyroid ◽  
Cervical Lymph Nodes ◽  
Study Objective

The study objective is to explore the potentialities of ultrasound in the detection of metastasis from papillary thyroid cancer (PTC) to cervical lymph nodes in levels II–IV.Materials and methods. In 97 patients with first diagnosed PTC, surgical removal of the cervical lymph node-bearing fat at levels II–IV was performed. All patients underwent preoperative neck ultrasound. The results were verified by histology.Results. Cervical levels II–IV lymph node metastases were revealed in 82 (84,5 %) cases by sonography and in 86 (88,6 %) cases by histology. Ultrasound showed a sensitivity of 93 %, specificity of 81 %, accuracy of 91 %, positive predictive value of 97 % and negative predictive value of 60 %. Of 1620 removed lymph nodes, 443 (27,3 %) showed metastases confirmed by histology. Sonography revealed 422 (26,0 %) metastatic lymph nodes. Metastasis from intra-thyroid tumors was noted in 94,1 % and from extra-thyroid tumors in 87,5 % of patients. Metastasis from solitary tumors occurred in 86,5 % and from multicentric tumors in 92,1 % of cases. Multiple metastases made up 89,5 % and solitary metastases – 10,5 %.Conclusion. Sonography is a highly informative diagnostic imaging method in detecting metastasis from PTC to levels II–IV cervical lymph nodes and can be used for basic assessment of thyroid abnormalities.

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