Diagnostic value of computed tomography combined with ultrasonography in detecting cervical recurrence in patients with thyroid cancer

Abstract

Background To determine the diagnostic role of CT added to ultrasound for the diagnosis of recurrent differentiated thyroid cancer (DTC) and to evaluate potential benefits for patients. Methods A total of 193 patients with recurrent DTC were retrospectively included. The diagnostic performances of ultrasound and combination of ultrasound and CT (ultrasound/CT) in detecting recurrence were compared. Benefits of CT were assessed based on the presence of any recurrence detected only with additional CT. Results In detecting cervical recurrence, ultrasound/CT showed higher sensitivity (P = .001) and lower specificity (P < .001) than ultrasound alone, overall resulting in higher area under the curve (P < .001). Seventy‐nine patients (40.9%) benefited from additional CT in detecting recurrence. Conclusion For reoperation of cervical recurrence in patients with DTC, addition of CT to ultrasound offers better surgical planning by enhancing detection of recurrent cancers that were overlooked with ultrasound alone.

2021 Korean Thyroid Imaging Reporting and Data System and Imaging-Based Management of Thyroid Nodules: Korean Society of Thyroid Radiology Consensus Statement and Recommendations

“…CT may also be used in cases where US may not adequately visualize disease recurrence, especially in those patients with high serum Tg or Tg antibodies and negative US [ 21 84 234 ]. A recent study demonstrated the added value of CT to US for the detection of thyroid cancer recurrence [ 262 ]. Before revision surgery or image-guided intervention, target lesions should be accurately identified using both US and CT [ 21 ].…”

Diagnostic Accuracy of Ultrasonography in Revision Thyroid Surgery: Can It Predict Disease Outcomes?

“…These modest detection rates may warrant the addition of computed tomography (CT) or a USG-guided FNAC in revision cases to avoid unnecessary reoperations. However, the literature for the same is not adequate, and a study by Hong et al recommends combining CT and USG to increase sensitivity in detecting cervical recurrence in thyroid cancers [18]. A meta-analysis by Zhao et al reported a sensitivity of 33%, 70%, specificity of 93%, 84% by USG, in detecting central and lateral neck nodes respectively among previously untreated patients with papillary thyroid cancer [19].…”