Comparison of ultrasonography and CT for preoperative nodal assessment of patients with papillary thyroid cancer: diagnostic performance according to primary tumor size

Yang, So Yeon; Shin, Jung Hee; Hahn, Soo Yeon; Lim, Yaeji; Hwang, Seok Young; Kim, Tae Hyuk; Kim, Jee Soo

doi:10.1177/0284185119847677

Cited by 17 publications

(18 citation statements)

References 21 publications

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“…Ultrasound is not sensitive to the diagnosis of metastatic LN-prRLN because of the interference from the trachea, esophagus, and surrounding tissues. Yang et al reported that the sensitivity, specificity, and accuracy of ultrasound for cervical lymph node metastasis in PTC patients were 38%, 88%, and 57%, respectively (14). It can be speculated that the diagnostic value of ultrasound for LN-prRLN is lower.…”

Section: Discussionmentioning

confidence: 99%

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A Novel Scoring System for Predicting the Metastases of Posterior Right Recurrent Laryngeal Nerve Lymph Node Involvement in Patients With Papillary Thyroid Carcinoma by Preoperative Ultrasound

Zhou

et al. 2021

Front. Endocrinol.

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ObjectiveOur goal was to investigate the correlation between papillary thyroid carcinoma (PTC) characteristics on ultrasonography and metastases of lymph nodes posterior to the right recurrent laryngeal nerve (LN-prRLN). There is still no good method for clinicians to judge whether a patient needs LN-prRLN resection before surgery, and we also wanted to establish a new scoring system to determine whether patients with papillary thyroid carcinoma require LN-prRLN resection before surgery.Patients and MethodsThere were 482 patients with right or bilateral PTC who underwent thyroid gland resection from December 2015 to December 2017 recruited as study subjects. The relationship between the PTC characteristics on ultrasonography and the metastases of LN-prRLN was analyzed by univariate and logistic regression analyses. Based on the risk factors identified in univariate and logistic regression analysis, a nomogram-based LN-prRLN prediction model was established.ResultLN-prRLN were removed from all patients, of which 79 had LN-prRLN metastasis, with a metastasis rate of 16.39%. Multivariate logistic regression analysis revealed that LN-prRLN metastasis was closely related to sex, age, blood supply, larger tumors (> 1 cm) and capsular invasion. A risk prediction model has been established and fully verified. The calibration curve used to evaluate the nomogram shows that the consistency index was 0.75 ± 0.065.ConclusionPreoperative clinical data, such as sex, age, abundant blood supply, larger tumor (> 1 cm) and capsular invasion, are positively correlated with LN-prRLN metastasis. Our scoring system can help surgeons non-invasively determine which patients should undergo LN-prRLN resection before surgery. We recommend that LN-prRLN resection should be performed when the score is above 103.1.

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Section: Discussionmentioning

confidence: 99%

“…Yang et al. reported that the sensitivity, specificity, and accuracy of ultrasound for cervical lymph node metastasis in PTC patients were 38%, 88%, and 57%, respectively ( 14 ). It can be speculated that the diagnostic value of ultrasound for LN-prRLN is lower.…”

Section: Discussionmentioning

confidence: 99%

A Novel Scoring System for Predicting the Metastases of Posterior Right Recurrent Laryngeal Nerve Lymph Node Involvement in Patients With Papillary Thyroid Carcinoma by Preoperative Ultrasound

Zhou

et al. 2021

Front. Endocrinol.

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“…For example, Yang et al. (18) used a scan delay time of 40 s for thyroid CT. Similarly, the scan delay time for enhanced CT scan was 45 s in Zhao et al.…”

Section: Discussionmentioning

confidence: 99%

“…The protocol for contrast injection during enhanced CT scan for thyroid varies markedly between previous studies (2,3,18–20). Several studies only used one delay time (mostly in the range of 35–60 s) for enhanced CT scan (18–20).…”

Section: Discussionmentioning

confidence: 99%

Texture analysis of dual-phase contrast-enhanced CT in the diagnosis of cervical lymph node metastasis in patients with papillary thyroid cancer

Zhou

et al. 2020

Acta Radiol

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Background Computed tomography texture analysis (CTTA) provides objective and quantitative information regarding tumor heterogeneity beyond visual inspection. However, no study has yet used CTTA to differentiate metastatic from non-metastatic cervical lymph node in patients with papillary thyroid cancer (PTC). Purpose To evaluate the value of texture analysis of dual-phase contrast-enhanced CT images in diagnosing cervical lymph node metastasis in patients with PTC. Material and Methods Metastatic (n = 27) and non-metastatic (n = 32) cervical lymph nodes were analyzed retrospectively. Texture analyses were performed on both arterial (A) and venous (V) phase CT images. Texture parameters, including mean gray-level intensity, skewness, kurtosis, entropy, and uniformity, were obtained and compared between groups. Receiver operating characteristic (ROC) curves analyses and multivariate logistic regression analysis were used in our study. Results Metastatic lymph nodes showed significantly higher A-mean gray-level intensity, A-entropy, and lower A-kurtosis and V-kurtosis (all P < 0.001) than non-metastatic mimics. The ROC curve analyses indicated that A-kurtosis demonstrated an optimal diagnostic area under the curve (AUC; 0.884) and specificity (92.59%), while the A-mean gray-level intensity showed optimal diagnostic sensitivity (90.62%). Multivariate logistic regression analysis showed that A-mean gray-level intensity ( P = 0.006, odds ratio [OR] = 24.297) and V-kurtosis ( P = 0.014, OR = 19.651) were the independent predictor for metastatic cervical lymph node. Conclusion Dual-phase contrast-enhanced CCTA—especially A-mean gray-level intensity and V-kurtosis—may have the potential to diagnose metastatic cervical lymph node in patients with PTC.

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“…Previous studies have shown that the estimated sensitivity of US in LNM prediction is low (38-59%) (15)(16)(17). Moreover, US is also limited in assessing central lymph nodes and superior mediastinal lymph nodes (18). FNAB is an invasive approach and its sensitivity in evaluating LNM varies and is specific to the operator (19).…”

Section: Introductionmentioning

confidence: 99%

MRI-based radiomics analysis to predict preoperative lymph node metastasis in papillary thyroid carcinoma

Hu¹,

Wei²,

Wang³

et al. 2020

Gland Surg

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Background:The aim of the present study was to develop a magnetic resonance imaging (MRI) radiomics model and evaluate its clinical value in predicting preoperative lymph node metastasis (LNM) in patients with papillary thyroid carcinoma (PTC).Methods: Data of 129 patients with histopathologically confirmed PTC were retrospectively reviewed in our study (90 in training group and 39 in testing group). 395 radiomics features were extracted from T2 weighted imaging (T2WI), diffusion weighted imaging (DWI) and T1 weighted multiphase contrast enhancement imaging (T1C+) respectively. Minimum redundancy maximum relevance (mRMR) was used to eliminate irrelevant and redundant features and least absolute shrinkage and selection operator (LASSO), to additionally select an optimized features' subset to construct the radiomics signature. Predictive performance was validated using receiver operating characteristic curve (ROC) analysis, while decision curve analyses (DCA) were conducted to evaluate the clinical worth of the four models according to different sequences. A radiomics nomogram was built using multivariate logistic regression model. The nomogram's performance was assessed and validated in the training and validation cohorts, respectively.Results: Seven key features were selected from T2WI, five from DWI, ten from T1C+ and seven from the combined images. The scores (Rad-scores) of patients with LNM were significantly higher than patients with non-LNM in both the training cohort and the validation cohort. The combined model performed better than the T2WI, DWI, and T1C+ models alone in both cohorts. In the training cohort, the area under the ROC (AUC) values of T2WI, DWI, T1C+ and combined features were 0.819, 0.826, 0.808, and 0.835, respectively; corresponding values in the validation cohort were 0.798, 0.798, 0.789, and 0.830. The clinical utility of the combined model was confirmed using the radiomics nomogram and DCA.Conclusions: MRI radiomic model based on anatomical and functional MRI images could be used as a non-invasive biomarker to identify PTC patients at high risk of LNM, which could help to develop individualized treatment strategies in clinical practice.

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Comparison of ultrasonography and CT for preoperative nodal assessment of patients with papillary thyroid cancer: diagnostic performance according to primary tumor size

Cited by 17 publications

References 21 publications

A Novel Scoring System for Predicting the Metastases of Posterior Right Recurrent Laryngeal Nerve Lymph Node Involvement in Patients With Papillary Thyroid Carcinoma by Preoperative Ultrasound

A Novel Scoring System for Predicting the Metastases of Posterior Right Recurrent Laryngeal Nerve Lymph Node Involvement in Patients With Papillary Thyroid Carcinoma by Preoperative Ultrasound

Texture analysis of dual-phase contrast-enhanced CT in the diagnosis of cervical lymph node metastasis in patients with papillary thyroid cancer

MRI-based radiomics analysis to predict preoperative lymph node metastasis in papillary thyroid carcinoma

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