Ying Zou1,2, Huanlei Zhang2,3, Wenfei Li2,4, Yu Guo5, Fang Sun2,6, Yan Shi6, Yan Gong2,7, Xiudi Lu1,2, Wei Wang8, Shuang Xia9. 1. Department of Radiology, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, No. 314 Anshan West Road, Nan Kai District, Tianjin, 300193, China. 2. Department of Radiology, First Central Clinical College, Tianjin Medical University, No. 24 Fu Kang Road, Nan Kai District, Tianjin, 300192, China. 3. Department of Radiology, Yidu central hospital of Weifang, No. 4138 Linglongshan nan Road, Qing Zhou City, Shandong, 262500, China. 4. Department of Radiology, The First Hospital of Qinhuangdao, No.258 Wenhua Road, Haigang District, Qinhuangdao, 066000, China. 5. Department of Radiology, Tianjin First Central Hospital, School of Medicine, Nankai University, No. 24 Fu Kang Road, Nan Kai District, Tianjin, 300192, China. 6. Department of Ultrasonography, Binzhou Medical University Hospital, No. 661 Huanghe 2nd Road, Binzhou City, 256603, Shandong, China. 7. Department of Radiology, Tianjin Hospital of ITCWM Nan Kai Hospital, No.6 Changjiang Road, Nan Kai District, Tianjin, 300100, China. 8. Department of Otorhinolaryngology, Tianjin First Central Hospital, No. 24 Fu Kang Road, Nan Kai District, Tianjin, 300192, China. 9. Department of Radiology, Tianjin First Central Hospital, School of Medicine, Nankai University, No. 24 Fu Kang Road, Nan Kai District, Tianjin, 300192, China. xiashuang77@163.com.
Abstract
BACKGROUND: Predicting the possibility of ipsilateral lateral cervical lymph node metastasis (ipsi-LLNM) was crucial to the operation plan for patients with papillary thyroid carcinoma (PTC). This study aimed to investigate the independent risk factors for ipsi-LLNM in PTC patients by combining dual-energy computed tomography (DECT) with thyroid function indicators. METHODS: We retrospectively enrolled 406 patients with a pathological diagnosis of PTC from Jan 2016 to Dec 2019. Ensure the DECT images were clear and the thyroid function indicators were complete. Univariate and multivariate logistic analyses explored the independent risk factors for ipsi-LLNM. To evaluate the cutoff value of each risk factor by using receiver operating characteristic (ROC) curves. RESULTS: A total of 406 patients with PTC were analyzed, including 128 with ipsi-LLNM and 278 without ipsi-LLNM. There were statistical differences of parameters between the two groups (P < .0001), including serum Tg, Anti-Tg, Anti-TPO, the volume of the primary lesion, calcification, extrathyroidal extension (ETE), and iodine concentration (IC) in the arterial and the venous phases. Independent risk factors for ipsi-LLNM included serum Tg, Anti-Tg, ETE, and IC in the arterial and the venous phases (P < .05). The combined application of the above independent risk factors can predict the possibility of ipsi-LLNM, with an AUC of 0.834. Ipsi-LLNM was more likely to occur when the following conditions were met: with ETE, Tg > 100.01 ng/mL, Anti-Tg > 89.43 IU/mL, IC in arterial phase > 3.4 mg/mL and IC in venous phase > 3.1 mg/mL. CONCLUSIONS: The combined application of DECT quantitative parameters and thyroid function indicators can help clinicians accurately predict ipsi-LLNM before surgery, thereby assisting the individualized formulation of surgical procedures.
BACKGROUND: Predicting the possibility of ipsilateral lateral cervical lymph node metastasis (ipsi-LLNM) was crucial to the operation plan for patients with papillary thyroid carcinoma (PTC). This study aimed to investigate the independent risk factors for ipsi-LLNM in PTCpatients by combining dual-energy computed tomography (DECT) with thyroid function indicators. METHODS: We retrospectively enrolled 406 patients with a pathological diagnosis of PTC from Jan 2016 to Dec 2019. Ensure the DECT images were clear and the thyroid function indicators were complete. Univariate and multivariate logistic analyses explored the independent risk factors for ipsi-LLNM. To evaluate the cutoff value of each risk factor by using receiver operating characteristic (ROC) curves. RESULTS: A total of 406 patients with PTC were analyzed, including 128 with ipsi-LLNM and 278 without ipsi-LLNM. There were statistical differences of parameters between the two groups (P < .0001), including serum Tg, Anti-Tg, Anti-TPO, the volume of the primary lesion, calcification, extrathyroidal extension (ETE), and iodine concentration (IC) in the arterial and the venous phases. Independent risk factors for ipsi-LLNM included serum Tg, Anti-Tg, ETE, and IC in the arterial and the venous phases (P < .05). The combined application of the above independent risk factors can predict the possibility of ipsi-LLNM, with an AUC of 0.834. Ipsi-LLNM was more likely to occur when the following conditions were met: with ETE, Tg > 100.01 ng/mL, Anti-Tg > 89.43 IU/mL, IC in arterial phase > 3.4 mg/mL and IC in venous phase > 3.1 mg/mL. CONCLUSIONS: The combined application of DECT quantitative parameters and thyroid function indicators can help clinicians accurately predict ipsi-LLNM before surgery, thereby assisting the individualized formulation of surgical procedures.
Authors: J M Debnam; N Guha-Thakurta; J Sun; W Wei; M E Zafereo; M E Cabanillas; N M Buisson; D Schellingerhout Journal: AJNR Am J Neuroradiol Date: 2020-04-23 Impact factor: 3.825
Authors: Saaduddin Siddiqui; Michael G White; Tatjana Antic; Raymon H Grogan; Peter Angelos; Edwin L Kaplan; Nicole A Cipriani Journal: Thyroid Date: 2016-05-17 Impact factor: 6.568