Contrast‑enhanced ultrasonography features of papillary thyroid carcinoma for predicting cervical lymph node metastasis

Liu, Ying; Zhou, Hong; Yang, Peng; Zhou, Yang; Wu, Jian; Chang-yu, Chen; Ye, Ming; Luo, Jing

doi:10.3892/etm.2017.5087

Cited by 18 publications

(23 citation statements)

References 38 publications

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“…A solid composition has not been shown to be associated with CLNM in previous studies; however, our results showed that it was an independent factor for CLNM. We hypothesized that this may be related to the higher blood flow density in solid lesions compared with mixed lesions, and a higher blood flow density was considered to be correlated with CLNM . The value of color Doppler imaging in the differential diagnosis of benign and malignant thyroid nodules is still controversial.…”

Section: Discussionmentioning

confidence: 99%

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

Tao

Zhou

Zhan

et al. 2020

J of Ultrasound Medicine

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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.

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Section: Discussionmentioning

confidence: 99%

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

Tao

Zhou

Zhan

et al. 2020

J of Ultrasound Medicine

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“…Zhang et al [14] revealed that the heterogeneous hypoechoic enhancement in PTC was the most valuable in predicting CLNM. On the contrary, Liu et al found that partial hyperenhancement in early ascending CEUS period was significantly higher in LNM + group than that in LNM-group [15]. As angiogenesis plays an important role in the development, growth, and metastases of PTC, it was hypothesized in our previous study [16] that the higher enhancements display at peak time is, the greater the microvascular density in PTC and the greater the possibility of neck LN metastasis may happen.…”

Section: Discussionmentioning

confidence: 76%

Homogeneity Parameter in Contrast-Enhanced Ultrasound Imaging Improves the Classification of Abnormal Cervical Lymph Node after Thyroidectomy in Patients with Papillary Thyroid Carcinoma

Zhan

Diao

Chen

et al. 2019

BioMed Research International

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Objective To explore the conventional and contrast-enhanced ultrasound (CEUS) features of cervical lymph node metastasis (CLNM) in papillary thyroid carcinoma (PTC) patients postoperatively and analyze its pathological basis. Materials and Methods Conventional and CEUS were performed in 86 abnormal cervical lymph nodes (ACLNs) from 56 PTC patients who had received thyroidectomy. Then, fine-needle aspiration (FNA) was taken to confirm pathological results, a multivariate analysis was performed to correlate the sonographic features of the CLNM, and then an equation for CLNM was established. Results Fifty-four lymph nodes were confirmed to be metastasis of PTC by FNA. Intensity at peak time, homogeneity, and color flow patterns, cystic change, or microcalcification and echogenicity were significantly associated with CLNM. Multivariate analysis showed three strongest features (homogeneity, intensity of peak, and cystic change or calcification) to be significantly associated with the evidence of CLNM. Then, the equation was established with the following significant predictive factors: P = 1/1 + exp∑[−3.213 + 2.77 ∗ cystic or calcification + 0.13 ∗ CDFI patterns + 3.65 ∗ homogeneity + 2.43 ∗ intensity at peak time]. Conclusion Depiction of a heterogeneous hyperenhancement of cervical lymph nodes within CEUS studies and cystic change or microcalcification in conventional ultrasound were identified as predictive for metastatic lymph node invasion, and the equation was more accurate for predicting CLNM compared to single B-mode ultrasound and CEUS feature.

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“…However, the need for a scoring system that performs better than the separate evaluation of single items is increasingly evident. Many different systems have been created in order to meet this need [ 16 , 17 ]; hypo-echogenicity, irregular margins, and the presence of microcalcifications are acknowledged to be risk factors for malignancy, while the role of intra-nodular vascularization is still debated [ 3 , 22 , 27 , 41 ].…”

Section: Discussionmentioning

confidence: 99%

“…Conventional ultrasound (US) has proved helpful in the management of these lesions, and several scoring systems with satisfactory accuracy and predictive value are now available [ 3 , 6 , 13 – 18 ]. While few data are available on the role of contrast-enhanced ultrasound (CEUS) in indeterminate-cytology nodules [ 19 ], its utility in distinguishing benign from malignant thyroid lesions and in the evaluation of cervical lymph nodes has already been proved [ 20 – 22 ]. Elastosonography is an emerging tool in the field of neck imaging and is particularly useful for the evaluation of thyroid nodules, especially if combined with conventional ultrasound [ 19 , 23 – 25 ].…”

Section: Introductionmentioning

confidence: 99%

Role of Strain Elastography and Shear-Wave Elastography in a Multiparametric Clinical Approach to Indeterminate Cytology Thyroid Nodules

et al. 2018

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BackgroundIn thyroid nodules with indeterminate cytology, further clinical assessment aimed at ruling out malignancy is often mandatory. Ancillary imaging techniques and genetic mutation analysis can improve the risk stratification of such lesions, thereby facilitating the clinician’s decision to undertaken surgery or simple follow-up. The aim of this study was to evaluate the diagnostic performance of shear-wave elastography (SW), strain elastography (ELX 2/1), conventional ultrasound (US), contrast-enhanced ultrasound (CEUS), and BRAF V600E mutation analysis in the aforementioned lesions.Material/MethodsWe enrolled 81 patients, each with 1 indeterminate-cytology thyroid nodule. Thyroid function, thyroperoxidase antibodies and calcitonin were known in each case. SW, ELX 2/1, US, CEUS, and BRAF mutation analysis were subsequently performed, followed by a second FNAB. If the lesion was not downgraded to benign, surgery was recommended and histological reports collected.ResultsThere were 28 nodules (34%) that proved benign on the second FNAB; 38 nodules (47%) underwent surgery (17 benign, 21 malignant), and 15 nodules (19%) refused surgery. The only techniques related to histological outcome were US (AUC=0,766), ELX 2/1 (AUC=0.701), and BRAF analysis (AUC=0.762). ELX 2/1 and SW reports were not correlated with each other (P=0.45). A scoring system taking into account all the variables considered performed better than the single variables alone (AUC=0.831).ConclusionsIn indeterminate-cytology thyroid lesions, repeating FNAB can avoid unnecessary surgery. ELX 2/1 seems to perform better than SW in distinguishing malignancy; these techniques could, however, be complementary in describing such lesions. A multiparametric approach appears the most accurate in predicting nodule histology.

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Contrast‑enhanced ultrasonography features of papillary thyroid carcinoma for predicting cervical lymph node metastasis

Cited by 18 publications

References 38 publications

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

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

Homogeneity Parameter in Contrast-Enhanced Ultrasound Imaging Improves the Classification of Abnormal Cervical Lymph Node after Thyroidectomy in Patients with Papillary Thyroid Carcinoma

Role of Strain Elastography and Shear-Wave Elastography in a Multiparametric Clinical Approach to Indeterminate Cytology Thyroid Nodules

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