Younghen Lee1, Ji-Hoon Kim2, Jung Hwan Baek3, So Lyung Jung4, Sun-Won Park5, Jinna Kim6, Tae Jin Yun2, Eun Ju Ha3,7, Kyu Eun Lee8, Soon Young Kwon9, Kyung-Sook Yang10, Dong Gyu Na11,12. 1. Department of Radiology, Korea University College of Medicine, Seoul, Korea. 2. Department of Radiology, Seoul National University Hospital and College of Medicine, Seoul, Korea. 3. Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. 4. Department of Radiology, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea. 5. Department of Radiology, Boramae Medical Center, College of Medicine, Seoul National University and College of Medicine, Seoul, Korea. 6. Department of Radiology, Severance Hospital, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, Korea. 7. Department of Radiology, Ajou University School of Medicine, Suwon, Korea. 8. Department of Surgery, Seoul National University Hospital and College of Medicine, Seoul, Korea. 9. Department of Otolaryngology - Head and Neck Surgery, Korea University College of Medicine, Seoul, Korea. 10. Department of Biostatistics, Korea University College of Medicine, Seoul, Korea. 11. Department of Radiology, Gang Neung Asan Hospital, Gangneung-si, Korea. 12. Department of Radiology, Human Medical Imaging and Intervention Center, Seoul, Korea.
Abstract
BACKGROUND: The benefit of CT for the diagnosis of lymph node metastasis in patients with thyroid cancer is still unclear. METHODS: Three hundred fifty-one patients with thyroid cancers from 7 hospitals were prospectively enrolled in order to compare diagnostic performance between a combination of ultrasound and CT (ultrasound/CT) and ultrasound alone for prediction of lymph node metastasis and to calculate patient-based benefits of CT added to ultrasound. RESULTS: Of 801 pathologically proven neck levels, ultrasound/CT showed higher sensitivities in both central and lateral compartments and improved accuracy in the lateral compartment compared to ultrasound alone. In the retropharyngeal/superior mediastinal compartment, although CT could detect lymph node metastasis an ultrasound could not. Patient-based benefit was demonstrated in 13.1% of patients (46/351), and was higher in patients with cancers >1 cm than cancers ≤1 cm. CONCLUSION: In patients with thyroid cancer, CT improved surgical planning by enhancing the sensitivity for lymph node metastasis and by detecting lymph node metastasis that was overlooked with ultrasound alone.
BACKGROUND: The benefit of CT for the diagnosis of lymph node metastasis in patients with thyroid cancer is still unclear. METHODS: Three hundred fifty-one patients with thyroid cancers from 7 hospitals were prospectively enrolled in order to compare diagnostic performance between a combination of ultrasound and CT (ultrasound/CT) and ultrasound alone for prediction of lymph node metastasis and to calculate patient-based benefits of CT added to ultrasound. RESULTS: Of 801 pathologically proven neck levels, ultrasound/CT showed higher sensitivities in both central and lateral compartments and improved accuracy in the lateral compartment compared to ultrasound alone. In the retropharyngeal/superior mediastinal compartment, although CT could detect lymph node metastasis an ultrasound could not. Patient-based benefit was demonstrated in 13.1% of patients (46/351), and was higher in patients with cancers >1 cm than cancers ≤1 cm. CONCLUSION: In patients with thyroid cancer, CT improved surgical planning by enhancing the sensitivity for lymph node metastasis and by detecting lymph node metastasis that was overlooked with ultrasound alone.
Authors: Se Jin Cho; Chong Hyun Suh; Jung Hwan Baek; Sae Rom Chung; Young Jun Choi; Jeong Hyun Lee Journal: Eur Radiol Date: 2019-02-26 Impact factor: 5.315