Preoperative Prediction of Cervical Lymph Node Metastasis in Papillary Thyroid Carcinoma via Conventional and Contrast‐Enhanced Ultrasound

Abstract

Objectives-To investigate the independent risk factors for cervical lymph node metastasis (CLNM) in patients with papillary thyroid carcinoma (PTC) and establish a prediction model via conventional ultrasound (US) and contrastenhanced ultrasound (CEUS). Methods-A total of 275 patients with single PTC, who were admitted to our hospital from January 2016 to December 2018, were enrolled in this study. The clinical characteristics and features of the tumor on conventional US and CEUS were retrospectively analyzed. A binary logistic regression model was established, and the diagnostic efficacy of conventional US and CEUS was compared. Results-The binary logistic regression analysis showed that age younger than 38 years, size of 10.0 mm or greater, solid composition, peak of the nodule interior of 28.3750 or greater, and area under the curve (AUC) of the peripheral ring of less than 3.2500 were independent risk factors of CLNM (P < .05, for all). Prediction model: Logit (p) = −4.135 + 1.040 (age) + 1.920 (size) + 1.769 (composition) + 1.230 (peak of nodule interior) + 0.812 (AUC of peripheral ring). The model positively predicted CLNM at a value of L > −0.199. The AUC, sensitivity, and negative predictive value of the receiver operating characteristic curve for the model were 0.727, 71.7%, and 75.2%, respectively, which were significantly higher than those of conventional US (Z = −2.403; P = .016; Z = −5.330; P < .001; and Z = −2.390; P = .017). The specificity of the model was 73.7%, which was lower than that of conventional US (Z = 3.508; P < .001). Conclusions-The preoperative prediction model established via conventional US and CEUS may be helpful to evaluate CLNM in patients with PTC and determine the appropriate treatment options.

Value of Contrast-Enhanced Ultrasound for Evaluation of Cervical Lymph Node Metastasis in Papillary Thyroid Carcinoma

“…Zhan et al found that iso-or hyperenhancement at peak time could predict cervical LNs metastasis in PTC patients (15). Tao et al reported that peak of the nodule interior of 28.3750 or greater, and AUC of the peripheral ring of less than 3.2500 were independent risk factors of cervical LNs metastasis in PTC patients (16). And other previous studies have directly studied the clinical application of CEUS in the differential diagnosis of benign and malignant LNs.…”

Analysis of the Relevance of the Ultrasonographic Features of Papillary Thyroid Carcinoma and Cervical Lymph Node Metastasis on Conventional and Contrast-Enhanced Ultrasonography

“…Previous studies found that the enhancement patterns of PTC on CEUS are a useful tool to predict CLNM ( 29 , 30 ). Hong ( 31 ) et al.…”

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

“…Therefore, preoperatively identified macroscopic metastatic LNs have prognostic significance and are regarded as clinically apparent metastatic LNs, whereas most micrometastatic nodes that are undetected by imaging have little clinical significance [ 134 ]. Recent studies have investigated the roles of advanced US imaging modalities, such as US elastography [ 149 150 151 152 153 ], contrast-enhanced US [ 154 155 156 157 ], and US microvascular imaging [ 158 ]. However, there are insufficient data on their clinical utility.…”