Role of computed tomography in the evaluation of regional metastasis in well-differentiated thyroid cancer

Frontiers in radiology Pub Date : 2023-10-31 DOI:10.3389/fradi.2023.1243000

Richa Vaish, Abhishek Mahajan, Nilesh Sable, Rohit Dusane, Anuja Deshmukh, Munita Bal, Anil K. D’cruz

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引用次数: 0

Abstract

Background Accurate neck staging is essential for performing appropriate surgery and avoiding undue morbidity in thyroid cancer. The modality of choice for evaluation is ultrasonography (US), which has limitations, particularly in the central compartment, that can be overcome by adding a computed tomography (CT). Methods A total of 314 nodal levels were analyzed in 43 patients with CT, and US; evaluations were done between January 2013 and November 2015. The images were reviewed by two radiologists independently who were blinded to histopathological outcomes. The sensitivity, specificity, negative predictive value (NPV), positive predictive value (PPV), and accuracy of US, CT, and US + CT were calculated using histology as the gold standard. Results The overall sensitivity, specificity, PPV, and NPV for US, CT, and US + CT were 53.9%, 88.8%, 74.1%, and 76.4%; 81.2%, 68.0%, 60.1%, and 85.9%; and 84.6%, 66.0%, 59.6%, and 87.8%, respectively. The overall accuracy of the US was 75.80%, the CT scan was 72.93%, and the US + CT scan was 72.93%. For the lateral compartment, the sensitivity, specificity, PPV, and NPV for the US, CT, and US + CT were 56.6%, 91.4%, 77.1%, and 80.5%; 80.7%, 70.6%, 58.3%, and 87.8%; and 84.3%, 68.7%, 57.9%, and 89.6%, respectively. The accuracy of the US was 79.67%, the CT scan was 73.98%, and the US + CT scan was 73.98% for the lateral compartment. For the central compartment, the sensitivity, specificity, PPV, and NPV for the US, CT, and US + CT were 47.1%, 76.5%, 66.7%, and 59.1%; 82.4%, 55.9%, 65.1%, and 76.0%; and 85.3%, 52.9%, 64.4%, and 78.3%, respectively. The accuracy of the US was 61.76%, the CT scan was 69.12%, and the US + CT scan was 69.12% for the central compartment. Conclusions This study demonstrated that CT has higher sensitivity in detecting nodal metastasis; however, its role is complementary to US due to low specificity.

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计算机断层扫描在评价高分化甲状腺癌局部转移中的作用

背景:准确的颈部分期对甲状腺癌进行适当的手术和避免过度的发病率至关重要。选择的评估方式是超声检查(US)，它有局限性，特别是在中央室，可以通过增加计算机断层扫描(CT)来克服。方法对43例患者的314个淋巴结水平进行CT和US分析;评估于2013年1月至2015年11月进行。图像由两名对组织病理学结果不知情的放射科医生独立审查。以组织学为金标准，计算US、CT和US + CT的敏感性、特异性、阴性预测值(NPV)、阳性预测值(PPV)和准确性。结果US、CT、US + CT的总体敏感性、特异性、PPV、NPV分别为53.9%、88.8%、74.1%、76.4%;81.2%、68.0%、60.1%、85.9%;分别为84.6%、66.0%、59.6%、87.8%。总体准确率为75.80%，CT扫描为72.93%，US + CT扫描为72.93%。对于侧室，US、CT和US + CT的敏感性、特异性、PPV和NPV分别为56.6%、91.4%、77.1%和80.5%;80.7%、70.6%、58.3%、87.8%;分别为84.3%、68.7%、57.9%、89.6%。US扫描的准确率为79.67%，CT扫描的准确率为73.98%，US + CT扫描对侧室的准确率为73.98%。对于中央室，US、CT和US + CT的敏感性、特异性、PPV和NPV分别为47.1%、76.5%、66.7%和59.1%;82.4%、55.9%、65.1%、76.0%;85.3%、52.9%、64.4%、78.3%。超声扫描的准确率为61.76%，CT扫描的准确率为69.12%，超声+ CT扫描的准确率为69.12%。结论CT对淋巴结转移有较高的敏感性;然而，由于特异性较低，其作用与US互补。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Frontiers in radiology

CiteScore

1.20

自引率

0.00%

发文量