Although ultrasound is routinely used for pre-operative evaluation of neck nodes in patients with papillary thyroid carcinoma, CT is also widely used. We designed a prediction score of lateral cervical lymph node metastasis (PSLCNM) for improving diagnostic ability of CT. The purpose of our study was to determine the clinical significance of the PSLCNM.

A total of 124 patients with thyroid carcinoma who underwent surgery of lateral cervical lymph node dissection after pre-operative CT evaluation were enrolled in this study. We retrospectively evaluated the diagnostic ability between CT findings by one radiologist and PSLCNM for prediction of lateral lymph node metastasis.

In terms of predicting lateral cervical node metastasis, the positive predictive value of CT findings of indeterminate, suspicious, or metastatic nodes were 37.5% (21/56), 68.3% (28/41), 85.7% (18/21). Those of 1, 2, 3, 4 in sum of PSLCNM were 34% (16/47), 60% (30/50), 91% (10/11), 100% (10/10).

Prediction of lateral cervical node metastasis using PSLCNM showed a better result than conventional CT findings and could decrease unnecessary surgical procedures and postoperative complications in the surgery of thyroid cancer.