Accuracy of MRI for the diagnosis of metastatic cervical lymphadenopathy in patients with thyroid cancer.
OBJECTIVE
The aim of this study was to systematically compare a comprehensive array of magnetic resonance (MR) imaging features in terms of their sensitivity and specificity to diagnose cervical lymph node metastases in patients with thyroid cancer.


METHODS
The study included 41 patients with thyroid malignancy who underwent surgical excision of cervical lymph nodes and had preoperative MR imaging ≤4weeks prior to surgery. Three head and neck neuroradiologists independently evaluated all the MR images. Using the pathology results as reference, the sensitivity, specificity and interobserver agreement of each MR imaging characteristic were calculated.


RESULTS
On multivariate analysis, no single imaging feature was significantly correlated with metastasis. In general, imaging features demonstrated high specificity, but poor sensitivity and moderate interobserver agreement at best.


CONCLUSIONS
Commonly used MR imaging features have limited sensitivity at correctly identifying cervical lymph node metastases in patients with thyroid cancer. A negative neck MR scan should not dissuade a surgeon from performing a neck dissection in patients with thyroid carcinomas.
UVA Department of Radiology, Neuroradiology Division, University of Virginia, Box 800170, Charlottesville, VA, 22908, USA.|Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing, China.
Qinghua
Q
Chen
UVA Department of Radiology, Neuroradiology Division, University of Virginia, Box 800170, Charlottesville, VA, 22908, USA.
Prashant
P
Raghavan
UVA Department of Radiology, Neuroradiology Division, University of Virginia, Box 800170, Charlottesville, VA, 22908, USA.
Sugoto
S
Mukherjee
Department of Otolaryngology - Head and Neck Surgery, University of Virginia, Charlottesville, VA, USA.
Mark J
MJ
Jameson
Department of Public Health Sciences, University of Virginia, Charlottesville, VA, USA.
James
J
Patrie
Department of Public Health Sciences, University of Virginia, Charlottesville, VA, USA.
Wenjun
W
Xin
Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing, China.
Junfang
J
Xian
Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing, China.
Zhenchang
Z
Wang
Department of Otolaryngology - Head and Neck Surgery, University of Virginia, Charlottesville, VA, USA.
Paul A
PA
Levine
UVA Department of Radiology, Neuroradiology Division, University of Virginia, Box 800170, Charlottesville, VA, 22908, USA. Max.Wintermark@gmail.com.|Department of Radiology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland. Max.Wintermark@gmail.com.
Max
M
Wintermark
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009333:Neck; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013964:Thyroid Neoplasms / Q000473:pathology*; D055815:Young Adult
Accuracy; MRI; Metastatic lymph nodes; Neck dissection; Thyroid cancer