Diagnostic Accuracy of Contrast-Enhanced Ultrasonography in Papillary Thyroid Microcarcinoma Stratified by Size

Huang, Kun; Bai, Zhiqun; Bian, Donglin; Yang, Puxu; Li, Xiangyi; Liu, Yanjun

doi:10.1016/j.ultrasmedbio.2019.10.001

Cited by 10 publications

(7 citation statements)

References 23 publications

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“…However, conventional ultrasound has certain limitations in the diagnosis of thyroid cancer metastasis. Previous studies ( 8 ) have demonstrated the feasibility of contrast-enhanced (CEUS) in the diagnosis of thyroid malignant nodules. CEUS is widely used to study tumor microcirculation, which is an important feature used to differentiate between benign and malignant tumors and determine the potential to metastasize ( 9 ).…”

Section: Introductionmentioning

confidence: 99%

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

Tian

Liu

et al. 2021

Front. Oncol.

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BackgroundPreoperative prediction of lymph node metastases has a major impact on prognosis and recurrence for patients with papillary thyroid carcinoma (PTC). Thyroid ultrasonography is the preferred inspection to guide the appropriate diagnostic procedure.PurposeTo investigate the relationship between PTC and cervical lymph node metastasis (CLNM, including central and lateral LNM) using both conventional ultrasound (US) and contrast-enhanced ultrasound (CEUS).Material and MethodsOur study retrospectively analyzed 379 patients diagnosed with PTC confirmed by surgical pathology at our hospital who underwent US and CEUS examinations from October 2016 to March 2021. Individuals were divided into two groups: the lymph node metastasis group and the nonmetastasis group. The relationship between US and CEUS characteristics of PTC and CLNM was analyzed. Univariate and multivariable logistic regression methods were used to identify the high-risk factors and established a nomogram to predict CLNM in PTC. Furthermore, we explore the frequency of CLNM at each nodal level in PTC patients.ResultsUnivariate analysis indicated that there were significant differences in gender, age, tumor size, microcalcification, contact with the adjacent capsule, multifocality, capsule integrity and enhancement patterns in CEUS between the lymph node metastasis group and the nonmetastasis group (all P<0.05). Multivariate regression analysis showed that tumor size ≥1 cm, age ≤45 years, multifocality, and contact range of the adjacent capsule >50% were independent risk factors for CLNM in PTC, which determined the nomogram. The diagnostic model had an area under the curve (AUC) of 0.756 (95% confidence interval, 0.707-0.805). And calibration plot analysis shown that clinical utility of the nomogram. In 162 PTC patients, the metastatic rates of cervical lymph nodes at levels I-VI were 1.9%, 15.4%, 35.2%, 34.6%, 15.4%, 82.1%, and the difference was statistically significant (P<0.001).ConclusionOur study indicated that the characteristics of PTC on ultrasonography and CEUS can be used to predict CLNM as a useful tool. Preoperative analysis of ultrasonographical features has important value for predicting CLNM in PTCs. The risk of CLNM is greater when tumor size ≥1 cm, age ≤45 years, multifocality, contact range of the adjacent capsule >50% are present.

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Section: Introductionmentioning

confidence: 99%

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

Tian

Liu

et al. 2021

Front. Oncol.

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“…It is easy to be misled and misdiagnosed. For this reason, it is necessary to perform imaging screening at the early stage of TT and conduct research and investigation for TT [ 3 , 4 ]. CEUS, as an important clinical imaging diagnostic method, has been promoted and expanded because of its meticulous imaging observation of TT and clear tumor nodules [ 5 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

Meta-Analysis of Contrast Enhanced Ultrasound in Judging Benign and Malignant Thyroid Tumors

Wan

Cao

Liu

2021

Computational and Mathematical Methods in Medicine

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In recent years, the incidence of thyroid cancer (TC) patients has gradually increased, and it ranks first among all endocrine tumors. TC has no obvious characteristics at the initial stage of onset. Thyroid tumors (TT) have formed when they are discovered, and they are easy to see when they are diagnosed. The disease is confused, so it is necessary to rely on imaging methods for tumor diagnosis. Contrast-enhanced ultrasound (CEUS), as the most commonly used imaging method in current clinical testing, is simple, safe, highly sensitive, can accurately display tumor conditions, and has high clinical value in the judgment of TC tumors. This article uses meta-analysis to select 63 published studies on CEUS to determine benign and malignant (BAM) TT to analyze and explore its clinical application value. This article understands the analysis of BAM TT and its diagnostic methods, clarifies the diagnostic efficiency of CEUS for TT, imaging methods, and imaging characteristics, and uses statistical analysis to analyze its heterogeneity. In this paper, the meta-analysis of CEUS in judging BAM TT is mainly based on references. The sensitivity, specificity, and difference of CEUS in diagnosing BAM TT are analyzed. Real-time elastography (RTE) is the comparison experiment object, and CEUS is used to compare the diagnostic efficiency, pathological results, and diagnostic efficiency of thyroid nodules in CEUS mode. The results of the study show that the nodule with higher diagnostic sensitivity is the echo feature, with a sensitivity of 97.73%, followed by the halo feature, with a sensitivity of 86.36%. In terms of diagnostic specificity, the boundary feature is the most specific. The specificity is 89.47%. In the judgment of BAM tumor nodules, the most obvious difference is the echo feature, which is as high as 14.09, followed by the acoustic halo feature, and the difference is 10.65.

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“…An accurate differential diagnosis can avoid unnecessary FNA or surgery for benign nodules. Hu [11] 2013 China a Prospective 51/57 20/31 47.4 ± 12.2 SonoVue (1.2 mL) c or d Chen et al [12] 2014 China a Prospective 216/258 49/167 NA SonoVue (1.0-1.2 mL) c Yan et al [13] 2014 China a Prospective NA/138 NA NA SonoVue (1.2 mL) c Li et al [8] 2015 China a Retrospective 73/80 21/52 39.5 ± 11.3 SonoVue (2.4 mL) c Wang et al [14] 2015 China a Prospective 98/109 30/68 44.8 ± 10.8 SonoVue (NA) c Yang [15] 2016 China a Retrospective 69/107 14/55 45.5 ± 8.4 NA c Ma et al [16] 2016 China a Prospective 125/135 NA 48.6 ± 12.0 SonoVue (2.4 mL) c Xu et al [17] 2017 China a Prospective 161/175 29/132 46.2 ± 15.2 SonoVue (2.5 mL) c or d Xu et al [18] 2017 China a Prospective 59/85 22/37 46.5 ± 3.3 SonoVue (NA) c or d Li [19] 2018 China a Prospective 154/185 27/127 48.7 ± 12.8 SonoVue (2.0 mL) c or d He et al [20] 2018 China a Prospective 496/564 228/268 39.2 ± 11.6 SonoVue (1.8 mL) c Jia [21] 2018 China a Retrospective 100/113 31/69 44.8 ± 9.8 SonoVue (2.4 mL) c Hao et al [22] 2019 China a Prospective 97/107 54/43 45.3 ± 3.7 SonoVue (NA) c Ci [23] 2019 China a Prospective 161/183 53/108 43.9 ± 11.1 SonoVue (2.4 mL) c Huang et al [24] 2019 [26] 2022 China b Prospective 45/60 14/31 47.6 ± 14.7 SonoVue (2.0 mL) c Tu [27] 2020 China a Prospective 40/58 16/24 48.2 ± 3.7 SonoVue (2.4 mL) c Wu [28] 2020 China a Prospective 60/60 19/41 50.0 ± 7.8 SonoVue (1.5 mL) c Liu et al [29] 2020 China a Retrospective 98/109 53/45 45.7 ± 8.1 SonoVue (NA) c or d Li [30] 2020 China a Prospective 75/93 29/46 38.7 ± 10.1 SonoVue (2.4 mL) c Peng and Cheng [31] 2020 China a Prospective 92/108 36/56 42.6 ± 10.6 NA (1.0 mL) c or d Zhang [32] 2020 China a Prospective 80/80 36/44 46.5 ± 5.8 Gd-DTPA (NA) c Liang [33] 2020 China a Prospective 106/106 NA NA NA (5.0 mL) c Wu et al [34] 2021 China a Retrospective 98/105 33/65 39 (18-67) SonoVue (2.0 mL) c Chen and Li [35] 2021 China a Prospective 65/74 25/40 42.0 ± 12.1 SonoVue (1.5 mL) c Zheng et al [36] 2021 China a Retrospective 92/106 40/52 45.0 ± 2.2 SonoVue (1.5 mL) c Li [37] 2021 China a Prospective 115/128 18/97 46.3 ± 6.5 SonoVue (2...…”

Section: Discussionmentioning

confidence: 99%

Diagnostic value of contrast-enhanced ultrasound in the diagnosis of papillary thyroid microcarcinoma: A systematic review and meta-analysis

Ding,

Peng,

Zhang

et al. 2024

Medicine

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Background: Using meta-analysis to evaluate the diagnostic value of contrast-enhanced ultrasound (CEUS) in the diagnosis of papillary thyroid microcarcinoma (PTMC). Methods: For this systematic review and meta-analysis, we searched PubMed, Cochrane Library, Web of Science, WanFang Data, VPCS Data, and China National Knowledge Infrastructure electronic databases for diagnostic studies on PTMC by CEUS from January 2013 to November 2022. Data were not available or incomplete such as case reports, nonhuman studies, etc, were excluded. Random-effects meta-analyses were used to evaluate the diagnostic accuracy of CEUS in diagnosing PTMC. The quality of the evidence was assessed with the QUADAS-2 scale. This study is registered on PROSPERO, number CRD42023409417. Results: Of 1064 records identified, 33 were eligible. The results showed that the pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio of CEUS in diagnosing PTMC were 0.84 (95% confidence interval [CI] = 0.83–0.86), 0.82 (95% CI = 0.80–0.83), 3.90 (95% CI = 3.23–4.72), 0.21 (95% CI = 0.18–0.25), and 20.01 (95% CI = 14.97–26.74), respectively, and the area under the summary receiver operating characteristic curve was 0.8930 (the Q index was 0.8239). The Deek funnel plot indicated publication bias (P ˂.01). Conclusion: This meta-analysis provides an overview of diagnostic accuracy of CEUS in diagnosing PTMC which indicates CEUS has a good diagnostic value for PTMC. The limitations of this study are publication bias and strong geographical bias.

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Diagnostic Accuracy of Contrast-Enhanced Ultrasonography in Papillary Thyroid Microcarcinoma Stratified by Size

Cited by 10 publications

References 23 publications

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

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

Meta-Analysis of Contrast Enhanced Ultrasound in Judging Benign and Malignant Thyroid Tumors

Diagnostic value of contrast-enhanced ultrasound in the diagnosis of papillary thyroid microcarcinoma: A systematic review and meta-analysis

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