Calcification Patterns in Papillary Thyroid Carcinoma are Associated with Changes in Thyroid Hormones and Coronary Artery Calcification

Nie

et al. 2021

CMAR

Purpose Early and accurate preoperative diagnosis of central lymph node metastasis (CLNM) is crucial to improve surgical management of patients with clinical lymph node-negative papillary thyroid carcinoma (PTC). Towards improving diagnosis of CLNM, we assessed the value of combining preoperative clinical characteristics, conventional ultrasound, and contrast-enhanced ultrasound (CEUS) in preoperative prediction of CLNM of different sized PTCs. Patients and Methods Patients were divided according to tumor size: a PTC group (>10 mm) and a papillary thyroid microcarcinoma (PTMC) group (≤10 mm). We retrospectively analyzed the clinical and ultrasonographic features of 120 PTC patients and 165 PTMC patients. Multivariate logistic regression analysis was used to screen independent risk factors and establish prediction models. Receiver operating characteristic curves were used to determine the best cut-off values for continuous variables and assess the performance of prediction models. Results Independent risk predictors of CLNM for the PTC group were extrathyroidal extension in CEUS (OR=7.923), tumor size >14 mm (OR=5.491), and multifocality (OR=3.235). For the PTMC group, the independent risk factors were the distance from the thyroid capsule =0 mm (OR=4.629), male (OR=3.315), tumor size >5 mm (OR=3.304), and microcalcification (OR=2.560). The predictive model of combined method had better performance in predicting CLNM of PTC compared with models based on CEUS and conventional ultrasound alone (area under the curve: 0.832 vs 0.739, P =0.0011; 0.832 vs 0.678, P =0.0012). For PTMC, comparing with CEUS, the combined method and conventional ultrasound performed better than CEUS alone in predicting CLNM (area under the curve: 0.783 vs 0.636, P =0.0016; 0.738 vs 0.636, P =0.0196). Conclusion The predictive models of combined method obtained from significant preoperative clinical and ultrasonographic features can potentially improve the preoperative diagnosis and individual treatment of CLNM in patients with PTC and PTMC. CEUS may be helpful in predicting CLNM of PTC, but CEUS would be ineffective in predicting CLNM of PTMC.

Section: Discussionmentioning

confidence: 99%

Value of Combining Clinical Factors, Conventional Ultrasound, and Contrast-Enhanced Ultrasound Features in Preoperative Prediction of Central Lymph Node Metastases of Different Sized Papillary Thyroid Carcinomas

Nie

et al. 2021

CMAR

International Journal of Hyperthermia

“…The nature of microcalcification is different from that of macrocalcification. The former is closely related to psammoma, while the latter is mainly interstitial calcification and ossification [33,34]. However, whether macrocalcification affected the efficacy of RFA is not clear.…”

Section: Discussionmentioning

confidence: 99%

Nomogram prediction for the involution of the ablation zone after radiofrequency ablation treatment in patients with low-risk papillary thyroid carcinoma

Zhang

Song

et al. 2021

“…Lymph node metastasis and extrathyroidal invasion are associated with aggressive features in PTC [ 16 , 29 – 31 ]. Of the concomitant PTC cases, 43.5% had lymph node metastasis and presented with extrathyroidal invasion, suggesting high-risk features [ 16 , 29 – 31 ]. A previous study reported that the optimal LNR threshold value for predicting PTC recurrence was 17.86% [ 32 ].…”

Section: Discussionmentioning

confidence: 99%

“…Microcarcinoma was defined as cancer where the greatest dimension was ≤1 cm. The calcification pattern was classified into the following three groups according to the consensus statement and recommendations proposed by the Korean Society of Thyroid Radiology and the Korean Society of Radiology [ 15 ]: (1) no calcification; (2) microcalcification defined as the presence of punctate echogenic foci of <1 mm with or without posterior shadowing; (3) macrocalcification defined as the presence of echogenic foci >1 mm with posterior shadowing [ 16 ]. The Korean Thyroid Imaging Reporting and Data System (K-TIRADS) was used to classify preoperative thyroid nodules for biopsy recommendation [ 17 ].…”

Section: Methodsmentioning

confidence: 99%

Association of Hyperparathyroidism and Papillary Thyroid Cancer: A Multicenter Retrospective Study

et al. 2020

Self Cite

Background: Concomitant papillary thyroid cancer (PTC) and hyperparathyroidism (HPT) have been reported in several studies. Our study aimed to investigate the incidence of concomitant PTC in HPT patients upon preoperative diagnosis and present a clinical opinion on detecting thyroid malignancy in case of parathyroidectomy.Methods: Patients who underwent parathyroidectomy between January 2009 and December 2019 in two medical centers were included. Of the 279 participants 154 were diagnosed as primary hyperparathyroidism (pHPT) and 125 as secondary hyperparathyroidism (sHPT). The incidence of concomitant PTC and its clinical characteristics were compared with 98 patients who underwent thyroidectomy and were diagnosed with classical PTC during the same period.Results: Concurrent PTC was detected in 14 patients (9.1%) with pHPT and in nine patients (7.2%) with sHPT. Ten (71.4%) and seven (77.8%) PTCs were microcarcinomas in the pHPT and sHPT cases respectively. In the pHPT patients, vitamin D was lower in the pHPT+PTC group (13.0±3.7 ng/mL) than in the pHPT-only group (18.5±10.4 ng/mL; P=0.01). Vitamin D levels were also lower in the sHPT+PTC group (12.3±5.6 ng/mL) than in the sHPT-only group (18.0±10.2 ng/mL; P=0.12). In the concomitant PTC group, lymph node ratio was higher than in the classical PTC group (P=0.00).Conclusion: A high prevalence of concomitant PTC was seen in patients with pHPT and sHPT. Those concomitant PTCs were mostly microcarcinomas and had more aggressive features, suggesting that efforts should be made to detect concomitant malignancies in the preoperative parathyroidectomy evaluation.