The sensitivity of preoperative scanning in regional recurrence of papillary thyroid cancer.
BACKGROUND
The treatment of patients with regionally recurrent papillary carcinoma of the thyroid is a matter of controversy. Radioactive nodal picking was proposed as an alternative to neck dissection in these patients.


METHODS
We analyzed neck dissection specimens in 20 patients with PTC and compared the results to preoperative total-body scan (TBS) following a therapeutic dose of I(131)and ultrasonographic findings.


RESULTS
Eighteen patients underwent paratracheal neck dissection and 10 patients had a lateral neck dissection. Preoperative TBS detected the correct number of positive nodes in only 1 patient (5%) and the correct number of patients with positive nodes in 6/20 (30%) of the patients. US detected 32/98 positive nodes (36%) and 20/20 (100%) of the patients. Prediction of the number of positive nodes for both TBS and US was low (5% and 10%, respectively).


CONCLUSIONS
Preoperative TBS and/or US cannot satisfactorily predict metastatic lymph node involvement and cannot safely delineate limited surgery to replace formal neck dissection in patients with regionally recurrent PTC.
Khafif
Avi
A
Department of Otolaryngology-Head and Neck Surgery, Tel-Aviv Sourasky Medical Center, Tel-Aviv University, Tel-Aviv, Israel. avironit@bezeqint.net
Ben-Yosef
Rami
R
Kesler
Ada
A
Trejo-Laider
Leonor
L
Landsberg
Roee
R
Patchornik
Hanna
H
Even-Sapir
Einat
E
Fliss
Dan M
DM
D000328:Adult; D000368:Aged; D002291:Carcinoma, Papillary / Q000175:diagnosis* / Q000556:secondary* / Q000628:therapy; D005260:Female; D006801:Humans; D007457:Iodine Radioisotopes / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection; D011237:Predictive Value of Tests; D011300:Preoperative Care; D019275:Radiopharmaceuticals / Q000627:therapeutic use; D013964:Thyroid Neoplasms / Q000473:pathology* / Q000628:therapy; D051598:Whole Body Imaging
D007457:Iodine Radioisotopes; D019275:Radiopharmaceuticals