title: The utility of routine preoperative cervical ultrasonography in patients undergoing thyroidectomy for differentiated thyroid cancer.
abstract: BACKGROUND
  Preoperative ultrasonography (US) is recommended in all patients with differentiated thyroid cancer (DTC) to evaluate for clinically occult metastatic lymphadenopathy. The purpose of this study was to examine the influence of preoperative US findings on the initial operative management of patients with DTC.
  
  
  METHODS
  This is a retrospective review of 70 patients with biopsy-proven DTC who underwent total thyroidectomy between February 2010 and January 2012. All patients underwent preoperative cervical US (thyroid, central, and lateral neck lymph node compartments).
  
  
  RESULTS
  Palpable lateral neck adenopathy was thought to be present in 5 (7%) of the 70 patients, but confirmed by US in only 3; 2 patients avoided lateral compartment neck dissection (LCND). Of 65 patients with no palpable lymphadenopathy, 14 (22%) had abnormal lymphadenopathy on preoperative US. All 14 patients underwent total thyroidectomy with central compartment neck dissection (CCND); 12 patients with abnormal US findings in the lateral compartment(s) also underwent LCND. Metastatic disease was confirmed in 13 (93%) of the 14 patients: 13 of 14 who underwent CCND and 11 (92%) of 12 who underwent LCND.
  
  
  CONCLUSIONS
  This study confirms the importance of preoperative, high-quality cervical US in patients with DTC because it changed the operative management in 16 of 70 patients (23%); 13 had a more complete operation for pathologically confirmed, clinically occult, lymph node metastases, 2 avoided nontherapeutic LCND, and 1 had false-positive US results.
authors.affiliation: Department of Surgery, Medical College of Wisconsin, Milwaukee, WI.
authors.forename: Kathleen
authors.initials: K
authors.lastname: O'Connell
authors.forename: Tina W
authors.initials: TW
authors.lastname: Yen
authors.forename: Francisco
authors.initials: F
authors.lastname: Quiroz
authors.forename: Douglas B
authors.initials: DB
authors.lastname: Evans
authors.forename: Tracy S
authors.initials: TS
authors.lastname: Wang
mesh_terms: D044963:Biopsy, Fine-Needle; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009333:Neck / Q000000981:diagnostic imaging*; D012189:Retrospective Studies; D013964:Thyroid Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D013965:Thyroidectomy; D014463:Ultrasonography