Prediction of distant metastases at diagnosis in medullary thyroid cancer: combining calcitonin with lymph node imaging

To our knowledge, this is the first study investigating the optimal combination of predictors for M1 disease in MTC at diagnosis. Suspicious lymph nodes on ultrasound is the strongest predictor for M1 disease, well exceeding calcitonin levels. Incorporating suspicious lymph nodes and calcitonin into a novel clinical decision tool may optimize M1 detection while reducing unnecessary imaging.