Accuracy of Ultrasound in Detection of Cervical Lymph Node Metastasis from Thyroid Cancer

Document Type : Original Article

Authors

1 Department of General Surgery, Faculty of Medicine, Al-Azhar University, Cairo, Egypt

2 Department of Surgical Oncology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt

3 Department of Diagnostic and Interventional Radiology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt

Abstract

Background: Thyroid cancer is often associated with regional lymph node metastasis, necessitating accurate detection pre-operatively. Ultrasound [U/S] is a widely used imaging modality for evaluating cervical lymph nodes, but its reliability for detecting metastatic lymph nodes in thyroid cancer remains to be elucidated.
Aim of the work: This study aimed to assess the accuracy of pre-operative neck ultrasound in detecting cervical lymph node metastasis in patients with thyroid nodules undergoing total thyroidectomy.
Patients and Methods: A total of 30 patients diagnosed with thyroid nodules were included in this study. All patients underwent comprehensive pre-operative neck ultrasound followed by total thyroidectomy. The histopathological examination of excised tissue served as the gold standard for comparison. The study particularly focused on analyzing the sensitivity, specificity, and overall accuracy of U/S in detecting both central and lateral lymph node metastasis.
Results: Among the 30 patients, 14 exhibited metastatic lateral lymph nodes [46.7%], and 5 presented with metastatic central lymph nodes [16.7%]. The sensitivity of U/S for central lymph node metastasis was found to be 58%, with a specificity of 97%, resulting in an overall accuracy of 81.3%. For lateral lymph node metastasis, the sensitivity was 70%, specificity 93%, and accuracy 83.6%.
Conclusion: This study highlights that while ultrasound demonstrates high specificity for detecting metastatic lymph nodes in thyroid cancer, its sensitivity remains moderate. Therefore, while U/S is a valuable tool in pre-operative evaluation, it should be complemented with other diagnostic modalities to enhance detection rates of lymph node metastasis.

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