Correlation between Ultrasonic Features of Medullary Thyroid Carcinoma and Cervical Lymph Node Metastasis

Zhu, Qiaodan; Shao, Zhaogang; Zhang, Xiao; Xu, Dong

doi:10.1016/j.ultrasmedbio.2020.12.023

Cited by 8 publications

(5 citation statements)

References 15 publications

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“…We assume a 10% rate of false negatives, which we believe is an appropriate risk, because in cases in which biochemical and/or structural persistence is detected early in the follow-up (given that these involve compartments that have not been operated on), a second operation should not entail added morbidity. Ultrasonography of the lateral compartments of the neck has a higher sensitivity and specificity than in the central compartment, which is interfered with by the thyroid glands [ 29 , 30 ].…”

Section: Discussionmentioning

confidence: 99%

Extension of Prophylactic Surgery in Medullary Thyroid Carcinoma. Differences Between Sporadic and Hereditary Tumours According to Calcitonin Levels and Lymph Node Involvement

et al. 2022

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Introduction Currently, there is no consensus on the indication of prophylactic surgery of the nodal compartments in the treatment of medullary thyroid carcinoma (MTC). The aim of our study was to perform a correlation study between preoperative calcitonin (basalCT) values and lymph node involvement to establish a criterion on which to base prophylactic surgery in these patients. Material and Methods We conducted an observational, retrospective and multicentre study with 29 hospitals. Patients over 18 years of age with a diagnosis of MTC with a pre-surgical calcitonin registry were included. The minimum surgery in all patients had to have been total thyroidectomy (TT) with central compartment lymph node dissection (CCLND). Receiver operating characteristic (ROC) curve analysis was used to establish basalCT cut-off values as predictors of postoperative lymph node involvement. Results A total of 244 patients were included. Baseline calcitonin (basalCT) was a good predictor of nodal involvement (AUC 0.718 and 95%CI 0.66–0.978). Heritability was identified as a preoperative factor correlated with baseline tumour CT values (p = 0.000). With a probability of lymph node involvement below 10%, new cut-off points were established. A prophylactic bilateral lateral lymph node dissection in sporadic tumours should be performed at a basalCT > 600 pg/mL; in the case of RET-mutated tumours this value would be 200 pg/mL. Conclusion The baseline CT value is a good predictor of postoperative lymph node involvement in MTC, however, cut-off points should depent on the hereditary nature of the tumour.

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Section: Discussionmentioning

confidence: 99%

Extension of Prophylactic Surgery in Medullary Thyroid Carcinoma. Differences Between Sporadic and Hereditary Tumours According to Calcitonin Levels and Lymph Node Involvement

et al. 2022

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“…The incidence of cervical LNM reaches 40–90% in PTC patients [ 23 ], and 2–8% in FTC patients, relatively lower, are more incline to the occurrence of hematogenous metastasis and low-frequency occurrence of LNM [ 24 , 25 ]. In contrast, MTC patients have a much higher incidence of cervical LNM, reaching 70% [ 26 , 27 ]. LNM is recognized as an independent risk factor for the high mortality rate of ATC, a rare disease with a very poor prognosis [ 28 ].…”

Section: Discussionmentioning

confidence: 99%

Clinical features and imaging examination assessment of cervical lymph nodes for thyroid carcinoma

Wei,

Yao,

Peng

et al. 2023

BMC Cancer

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Backgrounds The purpose of this study is to investigate the relationship between clinical characteristics and cervical lymph node metastasis (LNM) in patients with thyroid carcinoma, as well as estimate the preoperative diagnosis values of ultrasound (US) and contrast enhanced computed tomography (CECT) examinations on the neck for detection of cervical LNM in thyroid carcinoma. Methods A retrospective analysis of 3 026 patients with surgically proven thyroid carcinoma was conducted. Patients’ clinical characteristics, including gender, age, tumor size, bilateral lesions, multifocality, adenomatous nodules, Hashimoto’s thyroiditis (HT), and extrathyroidal extension, were collected to explore their association with cervical LNM in thyroid carcinoma. Preoperative assessments for central lymph node metastasis (CLNM) and lateral lymph node metastasis (LLNM) were conducted through US and CECT. The diagnostic value of US, CECT and US combined with CECT for detection of LNM located in various cervical compartments was estimated based on the pathological results. Results The risk of cervical LNM was higher in thyroid cancer patients who were male, age < 55 years old, tumor size > 10 mm, bilateral lesions, and extrathyroidal extension, while multifocality, adenomatous nodules and HT had no significant effect on LNM. US, CECT and US combined with CECT all had a higher sensitivity to LLNM (93.1%, 57.8%, 95.4%) than to CLNM (32.3%, 29.0%, 43.4%). US and CECT had a high specificity to both CLNM and LLNM (94.3–97.8%). Conclusion Preoperative clinical characteristics and imaging examinations on patients with thyroid carcinoma are crucial to the evaluation of cervical lymph nodes and conducive to individualizing surgical treatments by clinicians. US combined with CECT are superior to single US or CECT alone in detection of CLNM and LLNM.

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“…Nodules with a diameter of ≥10 mm were more susceptible to CLNM due to the presence of rich blood vessels in the tumor, which accelerates nodule growth. As nodules grow and enlarge, the likelihood of invasion of surrounding lymphatic vessels increases, thereby increasing the risk of metastasis [26][27][28]. Microcalcification contributes to the rapid growth of cancer cells and the proliferation of blood vessels and fibrous tissue within nodules [17].…”

Section: Discussionmentioning

confidence: 99%

Clinical value of ultrasound parameters PI, TTP, and MTT in assessing cervical lymph node metastasis of papillary thyroid carcinoma

Kong

2024

Am J Transl Res

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Objective: To determine the clinical value of ultrasound in assessing cervical lymph node metastasis (CLNM) in papillary thyroid carcinoma (PTC). Methods: The medical records of 179 PTC patients treated in Shandong Provincial Qianfoshan Hospital between March 2016 and March 2019 were collected. The patients were assigned to a transfer group (54 cases) and a non-transfer group (125 cases) according to their pathologic results. The ultrasound parameters (peak intensity (PI), time to peak (TTP), and mean transit time (MTT)) of the two groups were compared. Then, multivariate logistic regression was used to analysis the results, and receiver operating characteristic (ROC) curves were plotted to evaluate the value of risk factors in predicting CLNM. Results: The transfer group showed notably lower PI, TTP and MTT than the non-transfer group (P<0.001), and focus diameter, microcalcification, multiple foci, PI, TTP, and MTT were identified as independent risk factors for LNM in patients (P<0.05). According to the ROC curve, the areas under the curves (AUCs) of microcalcification, multiple foci, and PI were all smaller than 0.7; the AUCs of focus diameter and MTT were smaller than 0.8, and the AUC of TTP was 0.855. Conclusion: PI, TTP, and MTT all decrease in PTC patients with CLNM, and TTP has a strong predictor for CLNM in them, with an AUC of 0.855.

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Correlation between Ultrasonic Features of Medullary Thyroid Carcinoma and Cervical Lymph Node Metastasis

Cited by 8 publications

References 15 publications

Extension of Prophylactic Surgery in Medullary Thyroid Carcinoma. Differences Between Sporadic and Hereditary Tumours According to Calcitonin Levels and Lymph Node Involvement

Extension of Prophylactic Surgery in Medullary Thyroid Carcinoma. Differences Between Sporadic and Hereditary Tumours According to Calcitonin Levels and Lymph Node Involvement

Clinical features and imaging examination assessment of cervical lymph nodes for thyroid carcinoma

Clinical value of ultrasound parameters PI, TTP, and MTT in assessing cervical lymph node metastasis of papillary thyroid carcinoma

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