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Accuracy of MRI for the diagnosis of metastatic cervical lymphadenopathy in patients with thyroid cancer

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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.

Materials and 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.


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.


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.

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Conflict of interest

The authors have no disclosure.

Ethical standards

Ethical standards were respected and the Institute/Hospital Ethical Review Board has approved the study.

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Correspondence to Max Wintermark.

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Chen, Q., Raghavan, P., Mukherjee, S. et al. Accuracy of MRI for the diagnosis of metastatic cervical lymphadenopathy in patients with thyroid cancer. Radiol med 120, 959–966 (2015). https://doi.org/10.1007/s11547-014-0474-0

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  • Thyroid cancer
  • Neck dissection
  • Metastatic lymph nodes
  • MRI
  • Accuracy