Contrast-enhanced ultrasound characteristics of preoperative central cervical lymph node metastasis in papillary thyroid carcinoma

Ye, Fei; Gong, Yi; Tang, Kui; Xu, Yan; Zhang, Rongsen; Chen, Sijie; Li, Xiaodu; Zhang, Qi; Liao, Liyan; Zuo, Zhongkun; Niu, Chengcheng

doi:10.3389/fendo.2022.941905

Cited by 5 publications

(5 citation statements)

References 38 publications

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“…Several studies show the potential utility of CEUS in the differential diagnosis of benign and malignant thyroid nodules and in the analysis of lymph node involvement ( 21 ). The CEUS parameters including hyper-enhancement, centripetal perfusion, and ring enhancement are related to metastatic lymph nodes ( 15 , 22 ). However, few studies evaluated the association between CEUS features of PTC and lymph node metastasis.…”

Section: Discussionmentioning

confidence: 99%

Score based on contrast-enhanced ultrasound predict central lymph node metastasis in papillary thyroid cancer

He,

Chen,

et al. 2024

Front. Endocrinol.

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ObjectivesTo investigate the association between contrast-enhanced ultrasound (CEUS) features of PTC and central lymph node metastasis (CLNM) and to develop a predictive model for the preoperative identification of CLNM.MethodsThis retrospective study evaluated 750 consecutive patients with PTC from August 2020 to April 2023. Conventional ultrasound and qualitative CEUS features were analyzed for the PTC with or without CLNM using univariate and multivariate logistic regression analysis. A nomogram integrating the predictors was constructed to identify CLNM in PTC. The predictive nomogram was validated using a validation cohort.ResultsA total of 684 patients were enrolled. The 495 patients in training cohort were divided into two groups according to whether they had CLNM (pCLNM, n= 191) or not (nCLNM, n= 304). There were significant differences in terms of tumor size, shape, echogenic foci, enhancement direction, peak intensity, and score based on CEUS TI-RADS between the two groups. Independent predictive US features included irregular shape, larger tumor size (≥ 1.0cm), and score. Nomogram integrating these predictive features showed good discrimination and calibration in both training and validation cohort with an AUC of 0.72 (95% CI: 0.68, 0.77) and 0.79 (95% CI: 0.72, 0.85), respectively. In the subgroup with larger tumor size, age ≤ 35 years, irregular shape, and score > 6 were independent risk factors for CLNM.ConclusionThe score based on preoperative CEUS features of PTC may help to identify CLNM. The nomogram developed in this study provides a convenient and effective tool for clinicians to determine an optimal treatment regimen for patients with PTC.

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Section: Discussionmentioning

confidence: 99%

Score based on contrast-enhanced ultrasound predict central lymph node metastasis in papillary thyroid cancer

He,

Chen,

et al. 2024

Front. Endocrinol.

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“…Although PTCs have a favorable prognosis, other scholars contend that the central LNs are the most frequent sites for lymph node metastasis with a high incidence of 13.7%-72.2% ( 14 , 16 , 21 ). Thorough initial dissection with simultaneous dissection of the LN-prRLN is essential to reduce local recurrence and metastasis and avoid significant complication rates by secondary surgery.…”

Section: Discussionmentioning

confidence: 99%

“…CEUS, which provides more information about vascularity than conventional US, could reveal the thyroid nodule’s microvasculature and increase the diagnostic accuracy of thyroid nodules ( 12 , 13 ). Our previous studies found that preoperative CEUS characteristics could offer help in predicting central lymph node metastasis in PTCs with coexistent Hashimoto’s thyroiditis and identifying malignant cervical LNs from benign cervical LNs ( 14 – 16 ).…”

Section: Introductionmentioning

confidence: 99%

Multimodal predictive factors of metastasis in lymph nodes posterior to the right recurrent laryngeal nerve in papillary thyroid carcinoma

et al. 2023

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ObjectiveThe lymph node posterior to the right recurrent laryngeal nerve (LN-prRLN) is a crucial component of the central lymph nodes (LNs). We aimed to evaluate multimodal predictive factors of LN-prRLN metastasis in patients with papillary thyroid carcinomas (PTCs), including the clinical data, pathologic data, and preoperative sonographic characteristics of PTCs.MethodsA total of 403 diagnosed PTC patients who underwent unilateral, sub-total, or total thyroidectomy with central neck dissection were enrolled in this retrospective study. The clinical data, pathologic data, conventional ultrasound (US) and contrast-enhanced ultrasound (CEUS) characteristics of PTCs were collected and evaluated for predicting LN-prRLN metastasis.ResultsIn this study, 96 PTC patients with LN-prRLN metastasis and 307 PTC patients without LN-prRLN metastasis were included. Univariate analysis demonstrated that PTC patients with LN-prRLN metastasis more often had younger age, larger size, multifocal cancers, A/T < 1, well-margins, microcalcification, petal-like calcification, internal vascularity, centripetal perfusion pattern and surrounding ring enhancement. Multivariate logistic regression analysis revealed that the CEUS centripetal perfusion pattern, central LN detected by ultrasound and LN-arRLN metastasis were independent characteristics for predicting LN-prRLN metastasis in PTC patients.ConclusionAccording to our research, it is essential for clinicians to thoroughly dissect central LNs, particularly LN-prRLNs.

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“…Benign SCLNs were more likely to have no tumor history, which was consistent with previous research ( 13 ). For CUS features, well-defined margin, clear boundary, and long/short diameter ≥ 2 shape were commonly observed in benign lesions, but also occasionally seen in malignant lesions ( 14 ). The overlapping of CUS features and clinic data brings some difficulties in the diagnosis of benign and malignant lymph nodes.…”

Section: Discussionmentioning

confidence: 99%

Clinical features combined with ultrasound-based radiomics nomogram for discrimination between benign and malignant lesions in ultrasound suspected supraclavicular lymphadenectasis

Luo

Jin²,

Chen³

et al. 2023

Front. Oncol.

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BackgroundConventional ultrasound (CUS) is the first choice for discrimination benign and malignant lymphadenectasis in supraclavicular lymph nodes (SCLNs), which is important for the further treatment. Radiomics provide more comprehensive and richer information than radiographic images, which are imperceptible to human eyes.ObjectiveThis study aimed to explore the clinical value of CUS-based radiomics analysis in preoperative differentiation of malignant from benign lymphadenectasis in CUS suspected SCLNs.MethodsThe characteristics of CUS images of 189 SCLNs were retrospectively analyzed, including 139 pathologically confirmed benign SCLNs and 50 malignant SCLNs. The data were randomly divided (7:3) into a training set (n=131) and a validation set (n=58). A total of 744 radiomics features were extracted from CUS images, radiomics score (Rad-score) built were using least absolute shrinkage and selection operator (LASSO) logistic regression. Rad-score model, CUS model, radiomics-CUS (Rad-score + CUS) model, clinic-radiomics (Clin + Rad-score) model, and combined CUS-clinic-radiomics (Clin + CUS + Rad-score) model were built using logistic regression. Diagnostic accuracy was assessed by receiver operating characteristic (ROC) curve analysis.ResultsA total of 20 radiomics features were selected from 744 radiomics features and calculated to construct Rad-score. The AUCs of Rad-score model, CUS model, Clin + Rad-score model, Rad-score + CUS model, and Clin + CUS + Rad-score model were 0.80, 0.72, 0.85, 0.83, 0.86 in the training set and 0.77, 0.80, 0.82, 0.81, 0.85 in the validation set. There was no statistical significance among the AUC of all models in the training and validation set. The calibration curve also indicated the good predictive performance of the proposed nomogram.ConclusionsThe Rad-score model, derived from supraclavicular ultrasound images, showed good predictive effect in differentiating benign from malignant lesions in patients with suspected supraclavicular lymphadenectasis.

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Contrast-enhanced ultrasound characteristics of preoperative central cervical lymph node metastasis in papillary thyroid carcinoma

Cited by 5 publications

References 38 publications

Score based on contrast-enhanced ultrasound predict central lymph node metastasis in papillary thyroid cancer

Score based on contrast-enhanced ultrasound predict central lymph node metastasis in papillary thyroid cancer

Multimodal predictive factors of metastasis in lymph nodes posterior to the right recurrent laryngeal nerve in papillary thyroid carcinoma

Clinical features combined with ultrasound-based radiomics nomogram for discrimination between benign and malignant lesions in ultrasound suspected supraclavicular lymphadenectasis

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