Diagnostic yield of thyroid CT in differentiated thyroid carcinoma according to treatment response.

IF 4.7 2区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Radiology Pub Date : 2025-10-01 Epub Date: 2025-04-26 DOI:10.1007/s00330-025-11613-1

Yun Hwa Roh, Sae Rom Chung, Jung Hwan Baek, Young Jun Choi, Tae-Yon Sung, Dong Eun Song, Tae Yong Kim, Jeong Hyun Lee

{"title":"Diagnostic yield of thyroid CT in differentiated thyroid carcinoma according to treatment response.","authors":"Yun Hwa Roh, Sae Rom Chung, Jung Hwan Baek, Young Jun Choi, Tae-Yon Sung, Dong Eun Song, Tae Yong Kim, Jeong Hyun Lee","doi":"10.1007/s00330-025-11613-1","DOIUrl":null,"url":null,"abstract":"Objectives: To evaluate the diagnostic yield of thyroid CT in patients with post-treatment differentiated thyroid carcinoma (DTC) stratified by treatment response.Materials and methods: This retrospective study included DTC patients who underwent total thyroidectomy and radioactive iodine ablation, followed by thyroid CT. Patients were categorized into response assessment groups according to the American Thyroid Association guidelines: excellent response (ER), biochemical incomplete response (BIR), indeterminate response (IR), and structural incomplete response (SIR). Diagnostic yield was defined as the proportion of patients with recurrent tumors among all patients. The yields of ER, BIR, and IR were compared. For IR, subgroup analyses were performed based on the presence of indeterminate lesions on ultrasound (US). Chi-squared tests with Bonferroni correction were used to compare the diagnostic yields between groups.Results: A total of 450 patients (mean age, 44.9 ± 13.4 years; 164 men) were included. The overall diagnostic yield of thyroid CT was 15.3% (69/450; 95% confidence interval [CI]: 12.3-19%). Yields for the ER, BIR, and IR groups were 2% (4/201; 95% CI: 0.6-5.2%), 23.1% (12/52; 95% CI: 13.6-36.3%), and 26.9% (53/197; 95% CI: 21.2-33.5%), respectively. Among IR patients, the yield was significantly lower in US-negative patients (7.5%, 7/93; 95% CI: 3.5-15%) compared to those with indeterminate US lesions (44.2%, 46/104; 95% CI: 35.1-53.8%) (p < 0.001).Conclusion: The diagnostic yield of thyroid CT varies according to the treatment response; it was low in ER and US-negative IR but higher in BIR and IR with indeterminate US lesions.Key points: Question Guidelines recommend considering CT for follow-up in DTC based on treatment response, but the diagnostic yield of CT remains underexplored. Findings The diagnostic yield of CT was low in an ER and US-negative IR but higher in BIR and US-positive IR. Clinical relevance The diagnostic yield of thyroid CT varies according to treatment response. Utilizing CT based on treatment response may enhance the detection of recurrent tumors or clarify unclear findings on US.","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"5935-5943"},"PeriodicalIF":4.7000,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Radiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00330-025-11613-1","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/4/26 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}

引用次数: 0

Abstract

Objectives: To evaluate the diagnostic yield of thyroid CT in patients with post-treatment differentiated thyroid carcinoma (DTC) stratified by treatment response.

Materials and methods: This retrospective study included DTC patients who underwent total thyroidectomy and radioactive iodine ablation, followed by thyroid CT. Patients were categorized into response assessment groups according to the American Thyroid Association guidelines: excellent response (ER), biochemical incomplete response (BIR), indeterminate response (IR), and structural incomplete response (SIR). Diagnostic yield was defined as the proportion of patients with recurrent tumors among all patients. The yields of ER, BIR, and IR were compared. For IR, subgroup analyses were performed based on the presence of indeterminate lesions on ultrasound (US). Chi-squared tests with Bonferroni correction were used to compare the diagnostic yields between groups.

Results: A total of 450 patients (mean age, 44.9 ± 13.4 years; 164 men) were included. The overall diagnostic yield of thyroid CT was 15.3% (69/450; 95% confidence interval [CI]: 12.3-19%). Yields for the ER, BIR, and IR groups were 2% (4/201; 95% CI: 0.6-5.2%), 23.1% (12/52; 95% CI: 13.6-36.3%), and 26.9% (53/197; 95% CI: 21.2-33.5%), respectively. Among IR patients, the yield was significantly lower in US-negative patients (7.5%, 7/93; 95% CI: 3.5-15%) compared to those with indeterminate US lesions (44.2%, 46/104; 95% CI: 35.1-53.8%) (p < 0.001).

Conclusion: The diagnostic yield of thyroid CT varies according to the treatment response; it was low in ER and US-negative IR but higher in BIR and IR with indeterminate US lesions.

Key points: Question Guidelines recommend considering CT for follow-up in DTC based on treatment response, but the diagnostic yield of CT remains underexplored. Findings The diagnostic yield of CT was low in an ER and US-negative IR but higher in BIR and US-positive IR. Clinical relevance The diagnostic yield of thyroid CT varies according to treatment response. Utilizing CT based on treatment response may enhance the detection of recurrent tumors or clarify unclear findings on US.

查看原文本刊更多论文

甲状腺CT诊断分化型甲状腺癌的疗效分析。

目的：探讨甲状腺CT对治疗后分化型甲状腺癌（DTC）的诊断效果。材料和方法：本回顾性研究包括行甲状腺全切除术和放射性碘消融的DTC患者，随后行甲状腺CT检查。根据美国甲状腺协会指南将患者分为反应评估组：优异反应（ER）、生化不完全反应（BIR）、不确定反应（IR）和结构不完全反应（SIR）。诊断率定义为复发肿瘤患者占所有患者的比例。比较了ER、BIR和IR的收率。对于IR，基于超声（US）上不确定病变的存在进行亚组分析。采用Bonferroni校正的卡方检验比较两组间的诊断率。结果：共450例患者(平均年龄44.9±13.4岁；包括164名男性)。甲状腺CT的总体诊断率为15.3% (69/450；95%置信区间[CI]: 12.3-19%)。ER、BIR和IR组的产率为2% (4/201；95% ci: 0.6-5.2%), 23.1% (12/52；95% CI: 13.6-36.3%), 26.9% (53/197；95% CI: 21.2-33.5%)。在IR患者中，us阴性患者的产率显著降低(7.5%,7/93；95% CI: 3.5-15%)，而不确定US病变的患者(44.2%,46/104；结论：甲状腺CT的诊断率随治疗效果的不同而不同；ER和US阴性IR较低，但BIR和US不确定病变的IR较高。指南建议根据治疗效果考虑CT对DTC的随访，但CT的诊断率仍未得到充分探讨。发现CT对ER和us阴性IR的诊断率较低，而对BIR和us阳性IR的诊断率较高。甲状腺CT的诊断率随治疗效果的不同而不同。利用CT根据治疗反应可以提高肿瘤复发的发现或澄清不明确的发现。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

European Radiology 医学-核医学

CiteScore

11.60

自引率

8.50%

发文量

874

审稿时长

2-4 weeks

期刊介绍： European Radiology (ER) continuously updates scientific knowledge in radiology by publication of strong original articles and state-of-the-art reviews written by leading radiologists. A well balanced combination of review articles, original papers, short communications from European radiological congresses and information on society matters makes ER an indispensable source for current information in this field. This is the Journal of the European Society of Radiology, and the official journal of a number of societies. From 2004-2008 supplements to European Radiology were published under its companion, European Radiology Supplements, ISSN 1613-3749.