Predicting cervical lymph node metastasis in papillary thyroid carcinoma using capsule disruption length measured by 3D-US.

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

European Radiology Pub Date : 2025-10-17 DOI:10.1007/s00330-025-12070-6

Ruyu Liu, Yuxin Jiang, Xingjian Lai, Ying Wang, Luying Gao, Ruina Zhao, Xuehua Xi, Bo Zhang

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引用次数: 0

Abstract

Objectives: Papillary thyroid carcinoma (PTC) is a prevalent endocrine malignancy with a propensity for lymph node metastasis (LNM). Extrathyroidal extension (ETE) is a key factor in preoperative LNM prediction. The criteria for ultrasound diagnosis of ETE remain controversial. The aim is to determine if the length of capsule disruption (LCD) on three-dimensional ultrasound (3D-US) can predict cervical LNM in PTC patients.

Material and methods: A prospective cohort of 168 patients from Peking Union Medical College Hospital was examined by 3D-US. The LCD was measured using the omniview mode of 3D-US. Statistical analyses included Chi-square tests, T-tests, Mann-Whitney tests, ROC curve analysis, and logistic regression analysis.

Results: Of the 126 patients included, 71 had LNM. Younger age, male gender, larger malignant nodules, LCD, echogenic foci, and thyroid capsule invasion were significantly associated with LNM. LCD ≥ 0.42 cm increases LNM risk by 4.097 (p < 0.001). A nomogram was constructed incorporating gender, age, maximum diameter of the largest malignant nodule (MDLM), and LCD to estimate the risk of LNM. The accuracy and AUC of the nomogram were 73.0% and 0.795 (0.718-0.873).

Conclusions: LCD on 3D-US is a significant predictor of cervical LNM in PTC patients. This study's nomogram, based on easily measurable parameters, can help in the preoperative assessment of LNM risk, potentially guiding surgical management.

Key points: Question Can the LCD measured by 3D-US predict cervical LNM in PTC? Findings LCD ≥ 0.42 cm on 3D-US increase LNM risk by 4.097-fold. The nomogram with LCD, gender, age, and nodule size shows good predictive ability (AUC = 0.795). Clinical relevance LCD is a promising predictor of LNM, an alternative to ultrasound thyroid capsule invasion evaluation. The nomogram enables risk-adapted surgery, reducing unnecessary dissection or missed metastases to improve patient outcomes.

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3D-US测量囊破裂长度预测甲状腺乳头状癌颈部淋巴结转移。

目的：甲状腺乳头状癌（PTC）是一种常见的内分泌恶性肿瘤，具有淋巴结转移（LNM）的倾向。甲状腺外扩张（te）是术前预测LNM的关键因素。超声诊断ETE的标准仍有争议。目的是确定三维超声（3D-US）上的胶囊破裂长度（LCD）是否可以预测PTC患者的宫颈LNM。材料与方法：采用3D-US对北京协和医院168例患者进行前瞻性队列研究。LCD采用3D-US全景模式测量。统计分析包括卡方检验、t检验、Mann-Whitney检验、ROC曲线分析和logistic回归分析。结果：126例患者中，71例发生LNM。年龄小、男性、较大的恶性结节、LCD、回声灶、甲状腺囊浸润与LNM有显著相关性。LCD≥0.42 cm使LNM风险增加4.097 (p)。结论：3D-US上LCD是PTC患者宫颈LNM的重要预测因子。本研究的nomogram基于易于测量的参数，可以帮助术前评估LNM的风险，可能指导手术治疗。3D-US测量的LCD能否预测PTC的宫颈LNM ？发现LCD≥0.42 cm的3D-US， LNM风险增加4.097倍。与LCD、性别、年龄、结节大小相关的nomogram预测能力较好（AUC = 0.795）。液晶显示是一个有希望的预测LNM，替代超声甲状腺胶囊侵犯评估。nomography使风险适应手术，减少不必要的解剖或遗漏的转移，以改善患者的预后。

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

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.