Construction of a Diagnostic Model for Lymph Node Metastasis of the Papillary Thyroid Carcinoma Using Preoperative Ultrasound Features and Imaging Omics

Zhang, Chao; Cheng, Lihua; Zhu, Weiwen; Zhuang, Jian; Zhao, Tong; Li, Xiaoqin; Wang, Wenfeng

doi:10.1155/2022/1872412

Cited by 4 publications

(2 citation statements)

References 63 publications

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“…Our study also found similar trends, with multifocality and ETE being related to lateral LN metastasis, although central LN metastasis could not be evaluated due to the study’s design comparing N1b with N0. Many studies have shown that multifocality is a risk factor for LN metastasis in PTC and patients with PTMC ( 7 , 31 , 32 ), and there are still controversies regarding its relationship with prognosis. A recent study suggested that minimal ETE is linked to lateral LN metastasis ( 33 ), but there is no association between minimal ETE and recurrence among patients with PTMC ( 34 ).…”

Section: Discussionmentioning

confidence: 99%

Predictors of lateral lymph node metastasis and skip metastasis in patients with papillary thyroid microcarcinoma

Yoon,

Park,

Hong

et al. 2024

Front. Endocrinol.

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BackgroundPapillary thyroid microcarcinoma (PTMC) is characterized by its favorable prognosis and potential for active surveillance (AS) as a management option. However, the presence of cervical lymph node (LN) metastasis, especially lateral LN metastasis, significantly impacts management and prognosis. Previous studies have focused on post-surgery risk factors for cervical LN metastasis. This study aims to identify predictors of lateral LN metastasis by analyzing pre-operative ultrasonographic findings alongside clinicopathological factors.MethodsA retrospective review of medical records was conducted for patients with PTMC who underwent surgery at Chonnam National University Hwasun Hospital between 2004 and 2013. This is a case–control study that compares patients with lateral LN metastasis (N1b) to age- and sex-matched patients without LN metastasis (N0). Subgroup analysis was performed to evaluate risk factors of skip metastasis.ResultsThe study included 90 patients with PTMC with lateral LN metastasis (N1b) and 268 age- and sex-matched patients without LN metastasis (N0). The mean age was 49.3 years, and female patients were dominant in both groups. Structural recurrences of 4.4% (4/90) were observed only in the N1b group. The N1b group exhibited a higher frequency of upper lobe tumor location compared to the N0 group (38.9% vs. 16.0%, p < 0.001). There was no significant difference in the locations with the presence of invasion to adjacent organs. A higher proportion of non-parallel shape was observed in the N1b group than the N0 group (80.0% vs. 66.0%, p = 0.013). There were no differences in echogenicity, sonographic feature, margin, and AP diameter of the thyroid gland between the two groups. In multivariate analysis, independent risk factors for lateral LN metastasis included extrathyroidal extension, multiplicity, upper lobe tumor location, and non-parallel shape. Skip metastasis in patients with PTMC was associated with upper lobe tumor location.ConclusionDetailed ultrasound examinations, evaluating tumor location, number, orientation, and the presence of ETE, are crucial in accurately predicting lateral LN metastasis especially when primary tumor was in the upper lobe to avoid missing skip metastasis. These evaluations can help guide the decision between AS and immediate surgery in patients with PTMC.

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Section: Discussionmentioning

confidence: 99%

Predictors of lateral lymph node metastasis and skip metastasis in patients with papillary thyroid microcarcinoma

Yoon,

Park,

Hong

et al. 2024

Front. Endocrinol.

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“…Previously, the vast majority of research diagnostic models [11,12] focused on predicting the risk of benign and malignant thyroid nodules, cervical lymph node metastasis and postoperative recurrence. However, there are few preoperative evaluations of the clinical high risk of PTMC.…”

Section: Discussionmentioning

confidence: 99%

Construction and validation of a diagnostic model for high-risk papillary thyroid microcarcinoma

Liang,

Fan,

Qiu

et al. 2023

Preprint

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Objective The purpose of this study was to construct a diagnostic model by exploring the potential predictors of high-risk papillary thyroid microcarcinoma (PTMC) and verifying its reliability. Methods A retrospective analysis of PTMC patients who underwent surgical treatment from 2004 to 2015 in the SEER database (training set) and the clinical pathological ultrasound information of PTMC patients at the Sichuan Provincial People's Hospital from 2020 to 2022 (external validation set) was conducted. In the training set, univariate and multivariate logistic regression analyses were used to screen independent predictive factors for high-risk PTMC patients in pathology. A nomogram diagnostic model was further constructed. Additionally, ROC curves and calibration curves were drawn to evaluate the efficiency of the model. In the external validation set, the diagnostic model was indirectly evaluated based on preoperative ultrasound imaging features to explore the feasibility and reliability of diagnosing high-risk PTMC through preoperative ultrasound imaging features. Results A total of 1628 patients were included in the training set, and 530 patients were included in the test set. The independent risk factors for pathological high-risk PTMC were sex, age, tumor maximum diameter, tumor invasiveness, and cervical lymph nodes (P < 0.05). The C-index of the nomogram constructed based on these five factors was 0.947, with an optimal sensitivity of 96.7% and a specificity of 86.0%. The calibration curve showed that the model had high consistency. The area under the curve (AUC) value of the ROC curve for high-risk PTMC predicted by the risk score based on ultrasound features was 0.824 [95% CI (0.789, 0.860)], which was highly consistent with the risk score based on pathological features (κ = 0.758, P < 0.05). Conclusion Indirect evaluation of a high-risk PTMC diagnostic model based on preoperative ultrasound imaging features had high predictive efficiency and potential value for clinical application.

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Risk factor analysis and prediction model for papillary thyroid carcinoma with lymph node metastasis

Lu,

Liao,

Chen

et al. 2023

Front. Endocrinol.

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ObjectiveWe aimed to identify the clinical factors associated with lymph node metastasis (LNM) based on ultrasound characteristics and clinical data, and develop a nomogram for personalized clinical decision-making.MethodsA retrospective analysis was performed on 252 patients with papillary thyroid carcinoma (PTC). The patient’s information was subjected to univariate and multivariate logistic regression analyses to identify risk factors. A nomogram to predict LNM was established combining the risk factors. The performance of the nomogram was evaluated using receiver operating characteristic (ROC) curve, calibration curve, cross-validation, decision curve analysis (DCA), and clinical impact curve.ResultsThere are significant differences between LNM and non-LNM groups in terms of age, sex, tumor size, hypoechoic halo around the nodule, thyroid capsule invasion, lymph node microcalcification, lymph node hyperechoic area, peak intensity of contrast (PI), and area under the curve (AUC) of the time intensity curve of contrast (P<0.05). Age, sex, thyroid capsule invasion, lymph node microcalcification were independent predictors of LNM and were used to establish the predictive nomogram. The ROC was 0.800, with excellent discrimination and calibration. The predictive accuracy of 0.757 and the Kappa value was 0.508. The calibration curve, DCA and calibration curve demonstrated that the prediction model had excellent net benefits and clinical practicability.ConclusionAge, sex, thyroid capsule invasion, and lymph node microcalcification were identified as significant risk factors for predicting LNM in patients with PTC. The visualized nomogram model may assist clinicians in predicting the likelihood of LNM in patients with PTC prior to surgery.

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Construction of a Diagnostic Model for Lymph Node Metastasis of the Papillary Thyroid Carcinoma Using Preoperative Ultrasound Features and Imaging Omics

Cited by 4 publications

References 63 publications

Predictors of lateral lymph node metastasis and skip metastasis in patients with papillary thyroid microcarcinoma

Predictors of lateral lymph node metastasis and skip metastasis in patients with papillary thyroid microcarcinoma

Construction and validation of a diagnostic model for high-risk papillary thyroid microcarcinoma

Risk factor analysis and prediction model for papillary thyroid carcinoma with lymph node metastasis

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