Contribution of computed tomography to ultrasound in predicting lateral lymph node metastasis in patients with papillary thyroid carcinoma

Jung Hyun Yoon, Ji Youn Kim, Hee Jung Moon, Ji Hyun Youk, Eun Joo Son, Eun Kyung Kim, Kyung Hwa Han, Jin Young Kwak

Research output: Contribution to journalArticle

28 Citations (Scopus)

Abstract

Background: To evaluate the most accurate criteria using ultrasound (US) and contrast-enhanced computed tomography (CT) in predicting lateral lymph node metastasis in patients with papillary thyroid carcinoma (PTC). Methods: A total of 122 lateral cervical lymph nodes of 113 patients diagnosed with PTC underwent preoperative US-guided fine-needle aspiration biopsy (US-FNAB) and CT. Degree of enhancement (DOE) was calculated by the differences of Hounsfield units (HU) between the lymph node and the ipsilateral sternocleiomastoideus muscle. Standard reference was set by surgical pathology results. Diagnostic performances of US, CT, and cutoff value for DOE were analyzed. Results: Seventy lymph nodes (57.4%) were metastases, and 52 (42.6%) were benign. The cutoff value of DOE on CT was 35.7 HU. Diagnostic performance of CT including DOE of 35.7 HU was lower than US, but without significance (P = 0.321). When any suspicious CT feature was combined with the combination of suspicious US features, values of the area under the receiver operating characteristic curve decreased compared to the combinations of suspicious US features alone, 0.785 to 0.741, respectively (P = 0.225). Conclusions: Contrast-enhanced CT does not greatly improve diagnostic values of US in the diagnosis of metastatic lateral cervical lymph nodes in patients with PTC.

Original languageEnglish
Pages (from-to)1734-1741
Number of pages8
JournalAnnals of surgical oncology
Volume18
Issue number6
DOIs
Publication statusPublished - 2011 Jun 1

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Lymph Nodes
Tomography
Neoplasm Metastasis
Ultrasonography
Surgical Pathology
Fine Needle Biopsy
Papillary Thyroid cancer
ROC Curve
Muscles

All Science Journal Classification (ASJC) codes

  • Surgery
  • Oncology

Cite this

Yoon, Jung Hyun ; Kim, Ji Youn ; Moon, Hee Jung ; Youk, Ji Hyun ; Son, Eun Joo ; Kim, Eun Kyung ; Han, Kyung Hwa ; Kwak, Jin Young. / Contribution of computed tomography to ultrasound in predicting lateral lymph node metastasis in patients with papillary thyroid carcinoma. In: Annals of surgical oncology. 2011 ; Vol. 18, No. 6. pp. 1734-1741.
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abstract = "Background: To evaluate the most accurate criteria using ultrasound (US) and contrast-enhanced computed tomography (CT) in predicting lateral lymph node metastasis in patients with papillary thyroid carcinoma (PTC). Methods: A total of 122 lateral cervical lymph nodes of 113 patients diagnosed with PTC underwent preoperative US-guided fine-needle aspiration biopsy (US-FNAB) and CT. Degree of enhancement (DOE) was calculated by the differences of Hounsfield units (HU) between the lymph node and the ipsilateral sternocleiomastoideus muscle. Standard reference was set by surgical pathology results. Diagnostic performances of US, CT, and cutoff value for DOE were analyzed. Results: Seventy lymph nodes (57.4{\%}) were metastases, and 52 (42.6{\%}) were benign. The cutoff value of DOE on CT was 35.7 HU. Diagnostic performance of CT including DOE of 35.7 HU was lower than US, but without significance (P = 0.321). When any suspicious CT feature was combined with the combination of suspicious US features, values of the area under the receiver operating characteristic curve decreased compared to the combinations of suspicious US features alone, 0.785 to 0.741, respectively (P = 0.225). Conclusions: Contrast-enhanced CT does not greatly improve diagnostic values of US in the diagnosis of metastatic lateral cervical lymph nodes in patients with PTC.",
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Contribution of computed tomography to ultrasound in predicting lateral lymph node metastasis in patients with papillary thyroid carcinoma. / Yoon, Jung Hyun; Kim, Ji Youn; Moon, Hee Jung; Youk, Ji Hyun; Son, Eun Joo; Kim, Eun Kyung; Han, Kyung Hwa; Kwak, Jin Young.

In: Annals of surgical oncology, Vol. 18, No. 6, 01.06.2011, p. 1734-1741.

Research output: Contribution to journalArticle

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AU - Yoon, Jung Hyun

AU - Kim, Ji Youn

AU - Moon, Hee Jung

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AU - Son, Eun Joo

AU - Kim, Eun Kyung

AU - Han, Kyung Hwa

AU - Kwak, Jin Young

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N2 - Background: To evaluate the most accurate criteria using ultrasound (US) and contrast-enhanced computed tomography (CT) in predicting lateral lymph node metastasis in patients with papillary thyroid carcinoma (PTC). Methods: A total of 122 lateral cervical lymph nodes of 113 patients diagnosed with PTC underwent preoperative US-guided fine-needle aspiration biopsy (US-FNAB) and CT. Degree of enhancement (DOE) was calculated by the differences of Hounsfield units (HU) between the lymph node and the ipsilateral sternocleiomastoideus muscle. Standard reference was set by surgical pathology results. Diagnostic performances of US, CT, and cutoff value for DOE were analyzed. Results: Seventy lymph nodes (57.4%) were metastases, and 52 (42.6%) were benign. The cutoff value of DOE on CT was 35.7 HU. Diagnostic performance of CT including DOE of 35.7 HU was lower than US, but without significance (P = 0.321). When any suspicious CT feature was combined with the combination of suspicious US features, values of the area under the receiver operating characteristic curve decreased compared to the combinations of suspicious US features alone, 0.785 to 0.741, respectively (P = 0.225). Conclusions: Contrast-enhanced CT does not greatly improve diagnostic values of US in the diagnosis of metastatic lateral cervical lymph nodes in patients with PTC.

AB - Background: To evaluate the most accurate criteria using ultrasound (US) and contrast-enhanced computed tomography (CT) in predicting lateral lymph node metastasis in patients with papillary thyroid carcinoma (PTC). Methods: A total of 122 lateral cervical lymph nodes of 113 patients diagnosed with PTC underwent preoperative US-guided fine-needle aspiration biopsy (US-FNAB) and CT. Degree of enhancement (DOE) was calculated by the differences of Hounsfield units (HU) between the lymph node and the ipsilateral sternocleiomastoideus muscle. Standard reference was set by surgical pathology results. Diagnostic performances of US, CT, and cutoff value for DOE were analyzed. Results: Seventy lymph nodes (57.4%) were metastases, and 52 (42.6%) were benign. The cutoff value of DOE on CT was 35.7 HU. Diagnostic performance of CT including DOE of 35.7 HU was lower than US, but without significance (P = 0.321). When any suspicious CT feature was combined with the combination of suspicious US features, values of the area under the receiver operating characteristic curve decreased compared to the combinations of suspicious US features alone, 0.785 to 0.741, respectively (P = 0.225). Conclusions: Contrast-enhanced CT does not greatly improve diagnostic values of US in the diagnosis of metastatic lateral cervical lymph nodes in patients with PTC.

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