title: The role of lateral neck ultrasound in detecting single or multiple lymph nodes in papillary thyroid cancer.
abstract: BACKGROUND
  Lateral neck dissection (LND) for papillary thyroid cancer (PTC) transitioned from isolated lymphadenectomy or "berry picking" based on clinical examination to multicompartment lymphadenectomy. We aimed to assess ultrasound (US) as a predictor of solitary (SLN) or multiple lymph node (MLN) metastases.
  
  
  METHODS
  Demographics, US findings, extent of LND, and pathology were collected in patients with PTC who underwent LND. US sensitivity and specificity were calculated, and accuracy was correlated with US findings and patient characteristics.
  
  
  RESULTS
  A total of 462 patients underwent 590 LNDs. US showed an SLN in 179 patients (30%) and MLNs in 411 patients (70%). Sensitivity, positive predictive value, and accuracy were 61%, 43%, and 75% for US detected SLN and 78%, 89%, and 75% for US detected MLNs. US accuracy for MLNs increased as node size increased (<10 mm, 63%; 10 to 20 mm, 71%; >20 mm, 89%; P < .0001).
  
  
  CONCLUSIONS
  US has limited accuracy in the detection SLN metastasis in the lateral neck. Care should be taken when considering a focused compartment dissection.
authors: Department of Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
authors: Zahraa
authors: Z
authors: Al-Hilli
authors: Department of Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
authors: Veljko
authors: V
authors: Strajina
authors: Department of Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
authors: Travis J
authors: TJ
authors: McKenzie
authors: Department of Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
authors: Geoffrey B
authors: GB
authors: Thompson
authors: Department of Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
authors: David R
authors: DR
authors: Farley
authors: Department of Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA. Electronic address: Richards.melanie@mayo.edu.
authors: Melanie L
authors: ML
authors: Richards
mesh_terms: D000328:Adult; D002277:Carcinoma / Q000000981:diagnostic imaging* / Q000556:secondary* / Q000601:surgery; D002291:Carcinoma, Papillary; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D000077273:Thyroid Cancer, Papillary; D013964:Thyroid Neoplasms / Q000000981:diagnostic imaging* / Q000556:secondary* / Q000601:surgery; D013965:Thyroidectomy; D014463:Ultrasonography
keywords: Lateral neck dissection; Neck ultrasound; Papillary thyroid cancer