Utility of sonography for identifying metastatic cervical adenopathy in children with differentiated thyroid carcinoma at presentation

Study evaluates ultrasound accuracy for detecting cervical lymph node metastases in 52 children with differentiated thyroid carcinoma. Sonography showed 81% accuracy with high specificity (84%) and PPV (90%). Critically, 47% of metastatic nodes were normal in size/shape, identifiable only by abnormal echogenicity and vascularity—emphasizing these features are essential for pediatric thyroid cancer staging.