ISSN: 1859 - 2872
Ultrasonographic features of lymph node metastasis in differentiated thyroid cancer after total thyroidectomy
Main Article Content
Keywords
Abstract
Objective: To evaluate the diagnostic accuracy of ultrasonography (US) in detecting cervical neck lymph node metastasis (LNM) in patients with differentiated thyroid cancer (DTC). Subject and method: From September 2019 to February 2022, a total of 604 Lymph Nodes (LNs) from 301 enrolled DTC patients (63 men, 238 women; mean age: 47.4 ± 14.8 years; range: 16-84 years) were evaluated. According to the pathologic results, 405 LNs were metastatic, and 199 LNs were benign. US was performed with a 4-18 MHz linear transducer. The US criteria for LNM were as follows: Absence of hilum, irregular edge, focal or diffuse hyperechogenicity; microcalcification; cystic change; abnormal vascular pattern (a chaotic or peripheral vascular pattern); short axis > 5mm, and transverse/long diameter ratio > 0.5. Result: Diagnostic value of US signs for the detection of cervical metastatic lymph nodes from DTC, suspicious for malignancy (at least one sign), sensitivity 96.5%, specificity 43.7%, accuracy 79.1%, (at least two signs), sensitivity 85.7%, specificity 63.8%, accuracy 78.5%, and (at least three signs) sensitivity 76.5%, specificity 81.4%, accuracy 78.1%. Conclusion: High-quality ultrasonography is an established diagnostic tool for detecting detection of local-regional metastatic disease in patients with thyroid cancer.
Article Details
References
2. Eun Ju Ha, Sae Rom Chung, Dong Gyu Na, Hye Shin Ahn, Jin Chung, Ji Ye Lee, Jeong Seon Park (2021) 2021 Korean thyroid imaging reporting and data system and imaging-based management of thyroid nodules, korean society of thyroid radiology consensus statement and recommendations. Korean J Radiol 22 (12): 2094-2123.
3. Leenhardt MF, Erdogan L, Hegedus SJ, Mandel R, Paschke T, Rago G Russ (2013) European thyroid association guidelines for cervical ultrasound scan and ultrasound-guided techniques in the postoperative management of patients with thyroid cancer, Eur Thyroid J 2: 147-159.
4. Na Lae Eun, Eun Ju Son, Jeong-Ah Kim, Hye Mi Gweon, Jung-Hyun Kang, Ji Hyun Youk (2018) Comparison of the diagnostic performances of ultrasonography, CT and fine needle aspiration cytology for the prediction of lymph node metastasis in patients with lymph node dissection of papillary thyroid carcinoma: A retrospective cohort study. International Journal of Surgery 51: 145-150.
5. Qiaoqiao Wei, Daozhu Wu, Hongxia Luo, Xiaohua Wang, Rong Zhang, Yongfang Liu (2018) Features of lymph node metastasis of papillary thyroid carcinoma in ultrasonography and CT and the significance of their combination in the diagnosis and prognosis of lymph node metastasis. JBUON 23(4): 1041-1048.
6. Ramanujam P, Nirvikar D, Aya Ka, Shweta B, (2017) Chapter 5 ultrasound characteristics of benign vs malignant cervical lymph nodes. Semin Ultrasound CT MRI 38: 506-515. Published by Elsevier Inc.
7. Robenshtok E, Fish S, Bach A, Jose M Domínguez, Shaha A (2018) Suspicious cervical lymph nodes detected after thyroidectomy for papillary thyroid cancer usually remain stable over years in properly selected patients. Tuttle International Journal of Surgery 51: 145-150, Endocrinol Metab 97: 2706-2713.
8. So Yeon Yang, Jung Hee Shin, Soo Yeon Hahn, Yaeji Lim, Seok Young Hwang, Tae Hyuk Kim and Jee Soo Kim (2020) Comparison of ultrasonography and CT for preoperative nodal assessment of patients with papillary thyroid cancer: Diagnostic performance according to primary tumor size. Acta Radiologica 61(1): 21-27.
9. Yan DG, Zhang B, An CM et al (2011) Cervical lymph node metastasis in clinical N0 papillary thyroid carcinoma, Chin J Otorhinolaryngol Head Neck Surg 46(11): 887-891.
10. Yu-Mee Sohn, Jin Young Kwak Eun-Kyung Kim Hee Jung Moon Soo Jin Kim Min Jung Kim Sohn YM, Kwak JYK (2010) Diagnostic approach for evaluation of lymph node metastasis from thyroid cancer using ultrasound and fine-needle aspiration biopsy. AJR 194: 38-43.
11. Ying Wei, Ming an Yu, Yun Niu, Ying et al (2020) Combination of lymphatic and intravennous contrast -enhanced ultrasound for evaluation of cervical lymph node metastasis from papillary thyroid carcinoma: A preliminary study. Ultrasound in Medicine & Biology 00(00): 1-14.
Article Sidebar
