The Impact of Arterial Phase on the Detection of Cervical Lymph Node Metastasis From Papillary Thyroid Carcinoma: A Quantitative Evaluation on Multiphasic Computed Tomography

Çoruh, Ayşegül Gürsoy; Uzun, Çağlar; Kul, Melahat; Akkaya, Zehra; Elhan, Atilla Halil; Gökcan, Kürşat

doi:10.1097/rct.0000000000001005

Cited by 8 publications

(9 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This effect has been observed in normal sternal lymph nodes of dogs, where attenuation values increased significantly between precontrast and postcontrast images 20 . In a recent study of cervical lymph nodes in humans with thyroid cancer, a cutoff value of 109 HU in the arterial phase (25 s after contrast medium injection) yielded high sensitivity of 93.4% and specificity of 99.3% for the detection of metastasis 24 . In our cases, the median absolute density value 1 min after injection was significantly higher in positive SLNs than in normal ones, providing good accuracy (AUC 0.846) with a threshold value of 48.3 HU in the periphery of the lymph node.…”

Section: Discussionmentioning

confidence: 77%

Contrast enhanced computed tomography assessment of superficial inguinal lymph node metastasis in canine mammary gland tumors

Soultani

Patsikas

Mayer

et al. 2021

Vet Radiology Ultrasound

View full text Add to dashboard Cite

Mammary gland neoplasms are predominant in dogs. However, sentinel lymph node (SLN) status assessment criteria have not been established for these cases. In this retrospective, secondary analysis, diagnostic case control study, CT images of 65 superficial inguinal SLNs were obtained before and 1, 3, 5, and 10 min after intravenous administration of contrast agent (iopamidol 370 mgI/mL). The presence and degree of postcontrast enhancement were assessed, by means of the median absolute density value and the maximum absolute density value at any time point in the center and in the periphery of each SLN measured in Hounsfield units (HU), before and after contrast agent administration. These values were compared with histopathological findings postsurgical excision. Receiver operating characteristic analysis was conducted.The absolute density values ranged widely at each time point and within each group of nodes (negative, positive, control group). At all time points, the median density value in the center and in the periphery was significantly higher in metastatic than in nonmetastatic SLNs (P ≤ .014). Among the parameters tested, the median absolute density value measured in the periphery of the SLN 3 min after injection showed the highest sensitivity, specificity, and accuracy (AUC) (87.5%, 82.1%, and 92.1% respectively), with a cutoff value of 50.9 HU. The maximum absolute density value at any time point in the center and periphery of the SLNs was also significantly higher in metastatic SLNs compared to non-metastatic (P ≤ .001). With a cutoff value of 59.5 HU, the maximum absolute density value in the periphery of the SLN displayed high sensitivity and specificity (87.5% and 89.3%, respectively). The results of this study support the hypothesis that contrast enhanced CT imaging may aid in the assessment of SLN metastasis in dogs with mammary gland neoplasms.

show abstract

Section: Discussionmentioning

confidence: 77%

Contrast enhanced computed tomography assessment of superficial inguinal lymph node metastasis in canine mammary gland tumors

Soultani

Patsikas

Mayer

et al. 2021

Vet Radiology Ultrasound

View full text Add to dashboard Cite

show abstract

“…Gürsoy et al. ( 17 ) studied 272 LNs in 43 patients, and the results showed that the sensitivity and specificity were, respectively, 93.4% and 99.3%, with the cutoff value of EN HU 109 HU. Su et al.…”

Section: Discussionmentioning

confidence: 99%

“…( 16 ) and Gürsoy et al. ( 17 ) included the possible deviation of sample representativeness (too many LNs were selected in one patient) and the fact that the LNs did not reach or completely reach the level of comparison between pathology and imaging. The small sample size was the limitation of the study by Su et al.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic value of CT enhancement degree in lymph node metastasis of papillary thyroid cancer: A comparison of enhancement, ratio, and difference

et al. 2023

View full text Add to dashboard Cite

ObjectivesTo evaluate the value of computed tomography (CT) enhancement degree in diagnosing lymph node (LN) metastasis in papillary thyroid carcinoma (PTC) by determining the ratio and difference between the Hounsfield units (HU) of CT enhancement and plain scan of the LNs, as well as between the HU of CT-enhanced LNs and the sternocleidomastoid muscle.MethodsThe plain and enhanced CT findings of 114 metastasis-positive LNs in 89 cases and 143 metastasis-negative LNs in 114 cases of PTC were analyzed retrospectively. Plain HU of LNs (PNHU), enhanced HU of LNs (ENHU), and enhanced HU of the sternocleidomastoid muscle (EMHU) were measured. The ENHU, difference between ENHU and PNHU (EN-PNHU), ratio of ENHU to PNHU (EN/PNHU), difference between ENHU and EMHU (EN-EMHU), and ratio of ENHU to EMHU (EN/EMHU) in metastasis-positive and metastasis-negative LN groups were calculated, the corresponding diagnostic efficacy for differentiating metastasis-positive from metastasis-negative LNs in PTC were sought using the receiver-operating curve. The interobserver agreement between readers was assessed using the interobserver correlation coefficient (ICC).ResultsThe ENHU of 114 metastasis-positive LNs and 143 metastasis-negative LNs was 113.39 ± 24.13 and 77.65 ± 15.93, EN-PNHU was 65.84 ± 21.72 HU and 34.07 ± 13.63 HU, EN/PNHU was 2.36 (1.98, 2.75) and 1.76 (1.54, 2.02), EN-EMHU was 49.42 ± 24.59 HU and 13.27 ± 15.41 HU, and EN/EMHU was 1.79 ± 0.40 and 1.21 ± 0.24, respectively (all P < 0.001). The area under the curve, cutoff value, sensitivity, specificity, and accuracy of ENHU for identifying metastasis-positive and metastasis-negative LNs were 0.895, 97.3 HU, 0.746, 0.895, and 0.829, EN-PNHU was 0.894, 47.8 HU, 0.807, 0.874, and 0.844, EN/PNHU was 0.831, 1.9, 0.877, 0.650, and 0.751, EN-EMHU was 0.890, 26.4 HU, 0.807, 0.839, and 0.825, and EN/EMHU was 0.888, 1.5, 0.728, 0.902, and 0.825, respectively. The readers had an excellent interobserver agreement on these five parameters (ICC = 0.874–0.994).ConclusionIn the preoperative evaluation of LN metastasis in PTC, ENHU, EN-PNHU, EN-EMHU, and EN/EMHU had similarly high diagnostic efficacy, with ENHU, EN-PNHU, and EN/EMHU having higher specificity and EN-PNHU and EN-EMHU having higher sensitivity.

show abstract

“…The CT value of the carotid artery (CT‐a) in the same venous slice was measured as a reference, and the absolute enhancement CT value (ΔCT) was calculated by ΔCT = CT‐v − CT‐u 27 . The normalized enhancement CT value (NCT) was calculated by NCT = CT‐v/CT‐a 28 . 2) Enhancement homogeneity was classified as homogeneous or inhomogeneous (Figure 2, A and B).…”

Section: Methodsmentioning

confidence: 99%

Combined Conventional Ultrasound and Contrast‐Enhanced Computed Tomography for Cervical Lymph Node Metastasis Prediction in Papillary Thyroid Carcinoma

Zhao

Yue

Wang

et al. 2022

J of Ultrasound Medicine

View full text Add to dashboard Cite

Objectives-This study aimed to evaluate conventional ultrasound (US) combined with contrast-enhanced computed tomography (CT) of the neck to predict central lymph node metastasis (CLNM) in clinical lymphnegative patients with papillary thyroid carcinoma (PTC), establish a simple preoperative risk-scoring model, and validate its effectiveness in a two-center dataset.Methods-A total of 423 patients with PTC preoperatively evaluated by US and contrast-enhanced CT were included in the modeling group, and 102 patients from two hospitals were enrolled in the validation group. Independent predictive factors were determined using multivariate logistic regression analysis. Diagnostic performance was evaluated using receiver operating characteristic curve analysis.Results-The independent predictive factors for CLNM were age ≤45 years (odds ratio [OR] = 3.950), nodule presence in the non-upper pole (OR = 2.385), nodule size >12.5 mm (OR = 2.130), Thyroid Imaging Reporting and Data System score ≥9 (OR = 2.857), normalized enhancement CT value ≥0.75 (OR = 3.132), central enhancement (OR = 0.222), and capsular invasion (OR = 3.478). The area under the curve (AUC) of the model was 0.790 (95% confidence interval [CI]: 0.747-0.834), and the sensitivity and specificity were 70.4% and 73.9%, respectively. The AUC in the validation group was 0.827 (95% CI: 0.747-0.907), and the sensitivity and specificity were 88.9% and 63.2%, respectively.Conclusions-We found conventional US combined with contrast-enhanced CT of the neck to be useful in predicting CLNM preoperatively and established a simple risk-scoring model that might help surgeons with appropriate surgical plans and prognostic evaluation.

show abstract

The Impact of Arterial Phase on the Detection of Cervical Lymph Node Metastasis From Papillary Thyroid Carcinoma: A Quantitative Evaluation on Multiphasic Computed Tomography

Cited by 8 publications

References 26 publications

Contrast enhanced computed tomography assessment of superficial inguinal lymph node metastasis in canine mammary gland tumors

Contrast enhanced computed tomography assessment of superficial inguinal lymph node metastasis in canine mammary gland tumors

Diagnostic value of CT enhancement degree in lymph node metastasis of papillary thyroid cancer: A comparison of enhancement, ratio, and difference

Combined Conventional Ultrasound and Contrast‐Enhanced Computed Tomography for Cervical Lymph Node Metastasis Prediction in Papillary Thyroid Carcinoma

Contact Info

Product

Resources

About