Enhancing Surgical Accuracy in Papillary Thyroid Cancer: Computed Tomography-Guided Systematic Evaluation With the “A-C-T-V-L-A” Mnemonic

Papillary thyroid carcinoma frequently involves cervical lymph nodes, complicating surgical management and increasing recurrence risk.Ultrasonography, though commonly used, has limitations in assessing deeper or anatomically complex cervical structures.Computed tomography (CT) overcomes these limitations by providing reproducible, detailed anatomical visualization, aiding precise surgical planning.We propose a systematic mnemonic-based CT evaluation approach ("A-C-T-V-L-A") that encompasses critical anatomical checkpoints: aberrant subclavian artery, central neck compartment, thyroid gland or tumor, vocal fold, lateral neck compartment, and anterior jugular vein.This structured method enhances surgical accuracy by improving detection of metastatic nodes and anatomical variants, thereby minimizing recurrence and surgical complications.Further prospective studies are needed to confirm the clinical effectiveness of this mnemonic-guided assessment strategy.

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Publication Details

Journal
Journal of Endocrine Surgery
Published
2025-01-01
DOI
https://doi.org/10.16956/jes.2025.25.2.58
Primary Topic
Thyroid Cancer Diagnosis and Treatment
Type
article
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article

Enhancing Surgical Accuracy in Papillary Thyroid Cancer: Computed Tomography-Guided Systematic Evaluation With the “A-C-T-V-L-A” Mnemonic

June Young Choi
Journal of Endocrine Surgery
Thyroid Cancer Diagnosis and Treatment
article

Enhancing Surgical Accuracy in Papillary Thyroid Cancer: Computed Tomography-Guided Systematic Evaluation With the “A-C-T-V-L-A” Mnemonic

June Young Choi
article en

Abstract

Papillary thyroid carcinoma frequently involves cervical lymph nodes, complicating surgical management and increasing recurrence risk.Ultrasonography, though commonly used, has limitations in assessing deeper or anatomically complex cervical structures.Computed tomography (CT) overcomes these limitations by providing reproducible, detailed anatomical visualization, aiding precise surgical planning.We propose a systematic mnemonic-based CT evaluation approach ("A-C-T-V-L-A") that encompasses critical anatomical checkpoints: aberrant subclavian artery, central neck compartment, thyroid gland or tumor, vocal fold, lateral neck compartment, and anterior jugular vein.This structured method enhances surgical accuracy by improving detection of metastatic nodes and anatomical variants, thereby minimizing recurrence and surgical complications.Further prospective studies are needed to confirm the clinical effectiveness of this mnemonic-guided assessment strategy.

Journal of Endocrine SurgeryVol. 25(2)
Seoul National University Bundang Hospital (KR)
Good health and well-being
Openalex Percentile: Top 77%
Thyroid Cancer Diagnosis and Treatment
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