*1.5.1 Incidence of nonpalpable nodal metastasis*

Targeted physical examination of the neck is the important first step in detecting nodal metastasis in DTC but its sensitivity is variable. Palpable nodal disease has been reported in only around 5–10% of patients but the incidence of nonpalpable nodal metastasis is much higher. Mayo Clinic reported that ultrasonography (USG) detected nonpalpable nodal metastasis in up to 32% of their PTC cohort [4]. Particularly amongst patients with prior neck surgery, the nonpalpable nodal disease was up to 28 and 64% for the central and lateral compartment, respectively. This highlights the importance of preoperative radiological assessment for nodal metastasis.
