Role of Contrast-Enhanced Ultrasound in the Pre-operative Diagnosis of Cervical Lymph Node Metastasis in Patients with Papillary Thyroid Carcinoma

Hong, Yanjun; Luo, Zhi-yan; Mo, Guoqiang; Wang, Ping; Ye, Qin; Huang, Pintong

doi:10.1016/j.ultrasmedbio.2017.07.010

Cited by 50 publications

(91 citation statements)

References 33 publications

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“…Their results showed that heterogeneous enhancement, perfusion defects, microcalcification, and centripetal/hybrid enhancement were specific criteria for malignant lymph nodes in a univariate analysis. Furthermore, Hong et al [ 51 ] reported a similar conclusion.…”

Section: Ceus Detection Of Extrathyroid Extension or Neck Lymph Node mentioning

confidence: 56%

Application of contrast-enhanced ultrasound for evaluation of thyroid nodules

Zhan

Ding

2018

Ultrasonography

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Contrast-enhanced ultrasound (CEUS) is widely used to evaluate tumor microcirculation, which is useful in the differential diagnosis between benignity and malignancy. In the last 10 years, the applicability of CEUS to thyroid nodules has greatly improved due to technological refinements and the development of second-generation contrast agents. In this review, we summarize the applications of CEUS for thyroid nodules, focusing on the imaging findings of malignant and benign nodules in the existing literature and the use of those findings to predict malignancies, with an additional brief description of the utilization of CEUS for other thyroid-related diseases.

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Section: Ceus Detection Of Extrathyroid Extension or Neck Lymph Node mentioning

confidence: 56%

Application of contrast-enhanced ultrasound for evaluation of thyroid nodules

Zhan

Ding

2018

Ultrasonography

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“…With the development of ultrasound imaging and ultrasound elastography, its application in the diagnosis of lymph node metastasis is becoming more and more common. Contrast-enhanced ultrasound and elastography have been reported in the literature for preoperative diagnosis of PTC cervical lymph node metastasis[18-20]. However, regardless of contrast-enhanced ultrasound or elastography, the accuracy of individual diagnosis is unclear.…”

Section: Discussionmentioning

confidence: 99%

Value of contrast-enhanced ultrasound combined with elastography in evaluating cervical lymph node metastasis in papillary thyroid carcinoma

Jiang¹,

H²,

Zhang³

et al. 2019

WJCC

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BACKGROUNDCervical lymph node metastasis in papillary thyroid carcinoma (PTC) affects the treatment and prognosis of patients. Ultrasound is a common imaging method for detecting cervical lymph nodes in PTC patients; however, it is not accurate in determining lymph node metastasis.AIMTo evaluate the value of contrast-enhanced ultrasound combined with elastography in evaluating cervical lymph node metastasis in PTC.METHODSA total of 94 patients with PTC were recruited. According to pathological results, lymph nodes were divided into two groups: metastatic group (n = 50) and reactive group (n = 63). The routine ultrasound findings, contrast-enhanced ultrasound and elastography data were recorded and compared. Logistic regression was used to generate predictive probability distributions for the diagnosis of lymph node metastasis with different indicators. Receiver operating characteristic curve analysis was used to test the efficacy of contrast-enhanced ultrasound combined with elastography based on routine ultrasound in evaluating PTC cervical lymph node metastasis.RESULTSThe ratio of long diameter/short diameter (L/S) ≤ 2, irregular marginal morphology, missing lymphatic portal, peripheral or mixed blood flow distribution, peak intensity (PI), non-uniform contrast distribution and elasticity score in the metastatic group were significantly higher than those in the reactive group (P < 0.05). L/S ratio, missing lymphatic portal, PI and elasticity score had a significant influence on the occurrence of PTC cervical lymph node metastasis (P < 0.05). Furthermore, the area under the curve (AUC) for lymph node metastasis diagnosed using the combination of PI ratio, elasticity score, missing lymphatic portal and LS was 0.936, which was significantly higher than the AUC for PI ratio alone. The difference was statistically significant (P < 0.05). The fitting equation for the combined diagnosis was logit(P) = -12.341 + 1.482 × L/S ratio + 3.529 × missing lymphatic portal + 0.392 × PI + 3.288 × elasticity score.CONCLUSIONBased on the gray-scale ultrasound, the combination of contrast-enhanced ultrasound and elastography can accurately assess PTC cervical lymph node metastasis.

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“…Ethical approval was obtained from the Ethical Committees of Chinese PLA General Hospital. Inclusion criteria were: (1) patients received total or subtotal thyroidectomy for PTC, and at least one subsequent neck dissection; (2) patients who had contraindications for surgery or refused surgery, or refused to undergo further surgical resection and absent radioiodine uptake at post-therapeutic 131I whole-body scan; (3) patients with at least one metastatic lymph node (which were ready for treatment) confirmed by US-guided biopsy, or confirmed by US and CEUS (Figures 1 and 2) [26]; (4) no evidence of distant metastases. The flowchart of patient selection process was shown in Figure 3.…”

Section: Study Populationmentioning

confidence: 99%

Efficacy and safety of percutaneous ultrasound-guided microwave ablation for cervical metastatic lymph nodes from papillary thyroid carcinoma

Han

Dou

Cheng

et al. 2020

International Journal of Hyperthermia

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Purpose: Our purpose is to assess the efficacy and safety of percutaneous US-guided microwave ablation (MWA) for cervical metastatic lymph nodes from papillary thyroid carcinomas (PTC). Methods: In total, 37 patients with 98 cervical metastatic lymph nodes from PTC were enrolled in this retrospective study. Among them, 8 had subtotal thyroidectomy, 4 lobectomy, 2 no operation, and the rest total thyroidectomy. A multipoint and multiplane fixed ablation method was used. Monitoring of ablation process and clinical follow-up consisted of US or CEUS. Results: All 98 metastatic lymph nodes successfully treated in a single session with 100% complete ablation. The average longest and shortest diameter of the tumors were reduced from 13.21 ± 5.86 mm to 6.74 ± 5.66 mm (p ¼.00) and from 9.29 ± 4.09 mm to 4.31 ± 3.56 mm (p ¼.00) at the final follow-up. There were no evidence of recurrence at ablated sites. The common intraoperative complications were a burning sensation and pain. Only 3 patients had vagal reflex. Conclusions: US-guided MWA can effectively control cervical metastatic lymph nodes from PTC. MWA may become an alternative therapy in selected PTC patients with cervical lymph node metastasis.

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Role of Contrast-Enhanced Ultrasound in the Pre-operative Diagnosis of Cervical Lymph Node Metastasis in Patients with Papillary Thyroid Carcinoma

Cited by 50 publications

References 33 publications

Application of contrast-enhanced ultrasound for evaluation of thyroid nodules

Application of contrast-enhanced ultrasound for evaluation of thyroid nodules

Value of contrast-enhanced ultrasound combined with elastography in evaluating cervical lymph node metastasis in papillary thyroid carcinoma

Efficacy and safety of percutaneous ultrasound-guided microwave ablation for cervical metastatic lymph nodes from papillary thyroid carcinoma

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