Comparison between Ultrasonography and Computed Tomography for Detecting the Pyramidal Lobe of the Thyroid Gland: A Prospective Multicenter Study

Abstract

ObjectiveTo compare the detection rates of the pyramidal lobe of the thyroid gland (TPL) using ultrasonography (US) and computed tomography (CT) in a prospective multi-center study.Materials and MethodsWe enrolled 582 patients who underwent neck CT at six institutions. Each radiologist prospectively evaluated the presence and features of TPLs on thyroid US. Radiologists were divided into two groups according to their previous experience in detecting TPL on US or CT. The same radiologist also retrospectively assessed CT findings, blinded to the corresponding US findings.ResultsThe pyramidal lobe of the thyroid glands were detected in 230 cases (39.5%) on US and in 276 cases (47.6%) on CT. The TPL detection rate at the six institutions ranged from 22.0% to 59% for US and from 34.1% to 59% using CT. There were significant differences between US and CT in the detection rate, length, anteroposterior diameter, volume, and superior extent of TPL (p ≤ 0.027). The TPL detection rates on both US and CT (p < 0.001) differed significantly according to the experience level of the radiologists. When the CT result was used as a reference standard, the sensitivity, specificity, positive and negative predictive values, as well as the accuracy of US for TPL detection were 72.6%, 91.5%, 89.3%, 77.3%, and 82.1%, respectively.ConclusionOur prospective multicenter study revealed that US could detect TPL with relatively high diagnostic accuracy compared to CT. Because the detection rate of TPL varied significantly according to the radiologists' level of experience, careful inspection is necessary to avoid imaging pitfalls and ensure appropriate evaluation of TPL on both US and CT.

Pyramidal Lobe of the Thyroid Gland: Surgical Anatomy in Patients Undergoing Total Thyroidectomy

“…On the other hand, the PL was more frequent in female (62%) than male (50%) subjects in Zivic et al's series [ 8 ]. The incidence of PLs was also preoperatively determined with imaging modalities to be 41.3–59.3% by computed tomography and 37.5–58.5% by ultrasound (US) [ 7 , 13 – 16 ]. Because of the high incidence of the occurrence of the PL, thyroid surgeons should pay attention to the prelaryngeal region between the isthmus and the hyoid bone to remove all the thyroidal tissue during thyroidectomy.…”

Selection and Reporting of Statistical Methods to Assess Reliability of a Diagnostic Test: Conformity to Recommended Methods in a Peer-Reviewed Journal

“…Regarding the DTA studies, one reviewer experienced in DTA studies selected eligible articles according to criteria established elsewhere ( 9 ) with additional confirmation by another DTA expert in cases of ambiguity. Of the initial 124 candidate articles, 63 articles ( 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 ) were finally included. Regarding the studies that analyzed reliability, eligible articles were chosen by consensus after review by two of four independent reviewers experienced in the relevant methodology.…”

A Glimpse on Trends and Characteristics of Recent Articles Published in the Korean Journal of Radiology

“…KJR increasingly publishes meta-analyses (251525354555657585960), and guidelines (193161626364656667686970717273747576777879), and KJR also publishes consensus statements and recommendations (67808182) in collaboration with Korean Society of Radiology or other societies (68788384). Trends show increasing number of published articles with a prospective design and/or multicenter involvement in the studies (220214950858687888990919293949596979899100101102103104105106107108109110111112113114115116117118119120121122123124125126127). The numbers of articles with guidelines or consensus statements/recommendations were one in 2016, three in 2017, four in 2018, and 12 in 2019.…”