Pre-Surgery Ultrasound Lymph Node
Mapping for FNA proven
Or Suspicious Thyroid Cancer
Why Do It?

Papillary Thyroid Cancer Recurrence

15%-30% of patients with “successful” total thyroidectomy, have a recurrence. 90% are in the cervical lymph nodes. These occur despite of radioiodine ablative therapy.

Surgery, not Radiation is the best therapy for neck nodes. If this is correct, then finding cancer nodes prior to the first surgery will be even better, and may save recurrence related second surgery years later. High resolution Ultrasound lymph node mapping can detect these abnormal nodes, when MR, CT, RAI/131 Whole Body Scans, WBS, and PET are negative. Abnormal cancer Lymph nodes of 2-5 mm can be seen easily by Ultrasound. What if there is a palpable neck node? The US is still needed to map the entire neck. This mapping will alter the surgery in 40% of the patients, as it may find abnormal nodes in a different area or on the opposite side of the neck. The ultrasound mapping becomes a road map for the surgeon to find the non-palpable cancer nodes. 40% of patients have central compartment positive nodes. These may be found by ultrasound after the surgery, if a central compartment node removal is not done with the original thyroidectomy.

Reference: Mayo Clinic Endocrinology Update Vol. 3 #1 2008 p.1-2.