Diagnostic value of preoperative advanced doppler imaging with cervical maneuvers in the detection of central cervical lymph node metastasis in papillary thyroid carcinoma

Abstract Objective This study assesses the diagnostic value of preoperative greyscale and Doppler imaging and their combinative use with simultaneous advanced Doppler imaging and cervical maneuvers in detecting central cervical lymph node metastasis in papillary thyroid carcinoma patients. Methods I...

Full description

Saved in:
Bibliographic Details
Main Authors: Hosein Chegeni, Vahid Khani, Jalal Kargar, Abbas Alibakhshi, Khosro Shamsi, Hojat Ebrahiminik, Reza Gerami
Format: Article
Language:English
Published: BMC 2025-07-01
Series:BMC Medical Imaging
Subjects:
Online Access:https://doi.org/10.1186/s12880-025-01750-w
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Abstract Objective This study assesses the diagnostic value of preoperative greyscale and Doppler imaging and their combinative use with simultaneous advanced Doppler imaging and cervical maneuvers in detecting central cervical lymph node metastasis in papillary thyroid carcinoma patients. Methods In this cross-sectional survey, we included candidates for total or partial thyroidectomy with concomitant cervical lymph node dissection who referred to the TIRAD imaging center from February 2022 to September 2023 with papillary thyroid carcinoma diagnosis. Patients underwent preoperative ultrasonographic examination using the Aixplorer device (Supersonic Imagine, France) with a linear array transducer of 7.5–16 MHz to identify potential metastasis within the cervical lymph nodes. Ultrasonic assessments are presented using the totaling attributes such as sensitivity, specificity, positive and negative predictive values, and likelihood ratios. Results The post-operation pathology results showed metastasis in 85 (42.5%) patients. Standard imaging protocol without cervical approaches and advanced Doppler imaging capability detected metastatic involvement in 34 (17.0%) subjects. Meanwhile, the modified approach utilizing advanced Doppler imaging capability and cervical maneuvers identified metastatic involvement in 84 (42.0%) cases. The preoperative sensitivity without advanced Doppler imaging and maneuvers was 35.3%, specificity – 96.5%, positive predictive value – 88.2%, and negative predictive value – 66.9%. The introduction of advanced Doppler imaging and maneuvers yielded a sensitivity of 97.6%, specificity – of 99.1%, positive predictive value – 98.8%, and negative predictive value – 98.3%. Conclusion Advanced Doppler imaging can improve the visualization of the cervical areas, due to its ultrafast and ultrasensitive perception qualities, facilitating the early recognition of vascular pattern changes.
ISSN:1471-2342