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.