Preoperative Staging of Papillary Thyroid Carcinoma: Comparison of Ultrasound Imaging and CT
The purpose of this study was to compare the diagnostic accuracy of ultrasound imaging with that of CT in the preoperative evaluation of primary tumors and cervical lymph nodes in patients with papillary thyroid carcinoma and to determine whether CT has greater diagnostic value than ultrasound alone...
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| Veröffentlicht in: | American journal of roentgenology (1976) 2009-09, Vol.193 (3), p.871-878 |
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| container_title | American journal of roentgenology (1976) |
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| creator | Choi, Ji Soo Kim, Jinna Kwak, Jin Young Kim, Min Jung Chang, Hang Seok Kim, Eun-Kyung |
| description | The purpose of this study was to compare the diagnostic accuracy of ultrasound imaging with that of CT in the preoperative evaluation of primary tumors and cervical lymph nodes in patients with papillary thyroid carcinoma and to determine whether CT has greater diagnostic value than ultrasound alone in the care of these patients.
The study population consisted of 299 consecutively registered patients with pathologically proven papillary thyroid carcinoma. The diagnostic accuracies of ultrasound, CT, and the combination of ultrasound and CT in the evaluation of primary tumors and lymph node metastasis were compared. We performed subgroup analysis to compare the findings on papillary thyroid microcarcinoma (10 mm in maximum diameter or smaller) with the findings on papillary thyroid carcinoma larger than 1 cm in maximum diameter.
Ultrasound was more accurate than CT in prediction of the presence of extrathyroidal tumor extension and of malignant disease in both thyroid lobes (p < 0.05) for overall lesions and for the two subgroups. In prediction of central node (neck level VI) metastasis, CT had greater sensitivity than ultrasound alone (p = 0.04) for overall lesions. Although the combination of ultrasound and CT had greater sensitivity than ultrasound alone in prediction of the presence of central node metastasis in the two subgroups, the sensitivity of the combination of ultrasound and CT did not reach statistical significance for papillary thyroid microcarcinoma. Ultrasound alone and ultrasound with CT had greater sensitivity than CT in prediction of lateral node (levels II-V) metastasis, but there was no significant difference in diagnostic value between ultrasound and the combination of ultrasound and CT for overall lesions or for the two subgroups (p > 0.05).
High-resolution ultrasound can be accurate in preoperative evaluation for extrathyroidal tumor extension and lateral lymph node metastasis. CT had greater sensitivity than ultrasound alone in the detection of central lymph node metastasis for all lesions. For papillary thyroid microcarcinoma, however, there was no significant difference in the diagnostic accuracy rates of ultrasound, CT, and the combination of ultrasound and CT. |
| doi_str_mv | 10.2214/AJR.09.2386 |
| format | Article |
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The study population consisted of 299 consecutively registered patients with pathologically proven papillary thyroid carcinoma. The diagnostic accuracies of ultrasound, CT, and the combination of ultrasound and CT in the evaluation of primary tumors and lymph node metastasis were compared. We performed subgroup analysis to compare the findings on papillary thyroid microcarcinoma (10 mm in maximum diameter or smaller) with the findings on papillary thyroid carcinoma larger than 1 cm in maximum diameter.
Ultrasound was more accurate than CT in prediction of the presence of extrathyroidal tumor extension and of malignant disease in both thyroid lobes (p < 0.05) for overall lesions and for the two subgroups. In prediction of central node (neck level VI) metastasis, CT had greater sensitivity than ultrasound alone (p = 0.04) for overall lesions. Although the combination of ultrasound and CT had greater sensitivity than ultrasound alone in prediction of the presence of central node metastasis in the two subgroups, the sensitivity of the combination of ultrasound and CT did not reach statistical significance for papillary thyroid microcarcinoma. Ultrasound alone and ultrasound with CT had greater sensitivity than CT in prediction of lateral node (levels II-V) metastasis, but there was no significant difference in diagnostic value between ultrasound and the combination of ultrasound and CT for overall lesions or for the two subgroups (p > 0.05).
High-resolution ultrasound can be accurate in preoperative evaluation for extrathyroidal tumor extension and lateral lymph node metastasis. CT had greater sensitivity than ultrasound alone in the detection of central lymph node metastasis for all lesions. For papillary thyroid microcarcinoma, however, there was no significant difference in the diagnostic accuracy rates of ultrasound, CT, and the combination of ultrasound and CT.</description><identifier>ISSN: 0361-803X</identifier><identifier>EISSN: 1546-3141</identifier><identifier>DOI: 10.2214/AJR.09.2386</identifier><identifier>PMID: 19696304</identifier><identifier>CODEN: AAJRDX</identifier><language>eng</language><publisher>Reston, VA: Am Roentgen Ray Soc</publisher><subject>Adult ; Aged ; Biological and medical sciences ; Carcinoma, Papillary - diagnostic imaging ; Carcinoma, Papillary - pathology ; Carcinoma, Papillary - surgery ; Chi-Square Distribution ; Contrast Media ; Endocrinopathies ; Female ; Humans ; Image Interpretation, Computer-Assisted ; Investigative techniques, diagnostic techniques (general aspects) ; Iohexol - analogs & derivatives ; Lymphatic Metastasis - diagnostic imaging ; Lymphatic Metastasis - pathology ; Male ; Malignant tumors ; Medical sciences ; Middle Aged ; Miscellaneous. Technology ; Neoplasm Staging ; Non tumoral diseases. Target tissue resistance. Benign neoplasms ; Prospective Studies ; Thyroid Neoplasms - diagnostic imaging ; Thyroid Neoplasms - pathology ; Thyroid Neoplasms - surgery ; Thyroid. Thyroid axis (diseases) ; Tomography, X-Ray Computed ; Ultrasonic investigative techniques ; Ultrasonography</subject><ispartof>American journal of roentgenology (1976), 2009-09, Vol.193 (3), p.871-878</ispartof><rights>2009 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c456t-6f95db37efc6db6aa7ab71aa57534b590cc3b6fe88c6ca0c18614b1cdf7547fd3</citedby><cites>FETCH-LOGICAL-c456t-6f95db37efc6db6aa7ab71aa57534b590cc3b6fe88c6ca0c18614b1cdf7547fd3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,4106,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=21926958$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19696304$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Choi, Ji Soo</creatorcontrib><creatorcontrib>Kim, Jinna</creatorcontrib><creatorcontrib>Kwak, Jin Young</creatorcontrib><creatorcontrib>Kim, Min Jung</creatorcontrib><creatorcontrib>Chang, Hang Seok</creatorcontrib><creatorcontrib>Kim, Eun-Kyung</creatorcontrib><title>Preoperative Staging of Papillary Thyroid Carcinoma: Comparison of Ultrasound Imaging and CT</title><title>American journal of roentgenology (1976)</title><addtitle>AJR Am J Roentgenol</addtitle><description>The purpose of this study was to compare the diagnostic accuracy of ultrasound imaging with that of CT in the preoperative evaluation of primary tumors and cervical lymph nodes in patients with papillary thyroid carcinoma and to determine whether CT has greater diagnostic value than ultrasound alone in the care of these patients.
The study population consisted of 299 consecutively registered patients with pathologically proven papillary thyroid carcinoma. The diagnostic accuracies of ultrasound, CT, and the combination of ultrasound and CT in the evaluation of primary tumors and lymph node metastasis were compared. We performed subgroup analysis to compare the findings on papillary thyroid microcarcinoma (10 mm in maximum diameter or smaller) with the findings on papillary thyroid carcinoma larger than 1 cm in maximum diameter.
Ultrasound was more accurate than CT in prediction of the presence of extrathyroidal tumor extension and of malignant disease in both thyroid lobes (p < 0.05) for overall lesions and for the two subgroups. In prediction of central node (neck level VI) metastasis, CT had greater sensitivity than ultrasound alone (p = 0.04) for overall lesions. Although the combination of ultrasound and CT had greater sensitivity than ultrasound alone in prediction of the presence of central node metastasis in the two subgroups, the sensitivity of the combination of ultrasound and CT did not reach statistical significance for papillary thyroid microcarcinoma. Ultrasound alone and ultrasound with CT had greater sensitivity than CT in prediction of lateral node (levels II-V) metastasis, but there was no significant difference in diagnostic value between ultrasound and the combination of ultrasound and CT for overall lesions or for the two subgroups (p > 0.05).
High-resolution ultrasound can be accurate in preoperative evaluation for extrathyroidal tumor extension and lateral lymph node metastasis. CT had greater sensitivity than ultrasound alone in the detection of central lymph node metastasis for all lesions. For papillary thyroid microcarcinoma, however, there was no significant difference in the diagnostic accuracy rates of ultrasound, CT, and the combination of ultrasound and CT.</description><subject>Adult</subject><subject>Aged</subject><subject>Biological and medical sciences</subject><subject>Carcinoma, Papillary - diagnostic imaging</subject><subject>Carcinoma, Papillary - pathology</subject><subject>Carcinoma, Papillary - surgery</subject><subject>Chi-Square Distribution</subject><subject>Contrast Media</subject><subject>Endocrinopathies</subject><subject>Female</subject><subject>Humans</subject><subject>Image Interpretation, Computer-Assisted</subject><subject>Investigative techniques, diagnostic techniques (general aspects)</subject><subject>Iohexol - analogs & derivatives</subject><subject>Lymphatic Metastasis - diagnostic imaging</subject><subject>Lymphatic Metastasis - pathology</subject><subject>Male</subject><subject>Malignant tumors</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Miscellaneous. Technology</subject><subject>Neoplasm Staging</subject><subject>Non tumoral diseases. Target tissue resistance. Benign neoplasms</subject><subject>Prospective Studies</subject><subject>Thyroid Neoplasms - diagnostic imaging</subject><subject>Thyroid Neoplasms - pathology</subject><subject>Thyroid Neoplasms - surgery</subject><subject>Thyroid. Thyroid axis (diseases)</subject><subject>Tomography, X-Ray Computed</subject><subject>Ultrasonic investigative techniques</subject><subject>Ultrasonography</subject><issn>0361-803X</issn><issn>1546-3141</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpFkEFr2zAYhsVYadOup92HL9ulOJMsW7J2C2ZtMwoNawI9DMRnWUo0bMuV7IX--ykktKfvOzw8vO-L0GeC51lG8u-LX7_nWMwzWrIPaEaKnKWU5OQjmmHKSFpi-nyBLkP4izHmpeDn6IIIJhjF-Qz9WXntBu1htP908jTC1vbbxJlkBYNtW_CvyXr36p1tkgq8sr3r4EdSuW4Ab4PrD-imHT0EN_VNsuyOAoh_tf6Ezgy0QV-f7hXa3P5cV_fpw-Pdslo8pCov2JgyI4qmplwbxZqaAXCoOQEoeEHzuhBYKVozo8tSMQVYkZKRvCaqMbzIuWnoFfp29A7evUw6jLKzQekYv9duCpJxFrtTHMGbI6i8C8FrIwdvu1hSEiwPY8o4psRCHsaM9JeTdqo73byzp_Ui8PUEQFDQGg-9suGNy4jImCjK93w7u93trdcydNC2UUvkfr8ngkoqS07of4TPios</recordid><startdate>20090901</startdate><enddate>20090901</enddate><creator>Choi, Ji Soo</creator><creator>Kim, Jinna</creator><creator>Kwak, Jin Young</creator><creator>Kim, Min Jung</creator><creator>Chang, Hang Seok</creator><creator>Kim, Eun-Kyung</creator><general>Am Roentgen Ray Soc</general><general>American Roentgen Ray Society</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20090901</creationdate><title>Preoperative Staging of Papillary Thyroid Carcinoma: Comparison of Ultrasound Imaging and CT</title><author>Choi, Ji Soo ; Kim, Jinna ; Kwak, Jin Young ; Kim, Min Jung ; Chang, Hang Seok ; Kim, Eun-Kyung</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c456t-6f95db37efc6db6aa7ab71aa57534b590cc3b6fe88c6ca0c18614b1cdf7547fd3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2009</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Biological and medical sciences</topic><topic>Carcinoma, Papillary - diagnostic imaging</topic><topic>Carcinoma, Papillary - pathology</topic><topic>Carcinoma, Papillary - surgery</topic><topic>Chi-Square Distribution</topic><topic>Contrast Media</topic><topic>Endocrinopathies</topic><topic>Female</topic><topic>Humans</topic><topic>Image Interpretation, Computer-Assisted</topic><topic>Investigative techniques, diagnostic techniques (general aspects)</topic><topic>Iohexol - analogs & derivatives</topic><topic>Lymphatic Metastasis - diagnostic imaging</topic><topic>Lymphatic Metastasis - pathology</topic><topic>Male</topic><topic>Malignant tumors</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Miscellaneous. Technology</topic><topic>Neoplasm Staging</topic><topic>Non tumoral diseases. Target tissue resistance. Benign neoplasms</topic><topic>Prospective Studies</topic><topic>Thyroid Neoplasms - diagnostic imaging</topic><topic>Thyroid Neoplasms - pathology</topic><topic>Thyroid Neoplasms - surgery</topic><topic>Thyroid. Thyroid axis (diseases)</topic><topic>Tomography, X-Ray Computed</topic><topic>Ultrasonic investigative techniques</topic><topic>Ultrasonography</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Choi, Ji Soo</creatorcontrib><creatorcontrib>Kim, Jinna</creatorcontrib><creatorcontrib>Kwak, Jin Young</creatorcontrib><creatorcontrib>Kim, Min Jung</creatorcontrib><creatorcontrib>Chang, Hang Seok</creatorcontrib><creatorcontrib>Kim, Eun-Kyung</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>American journal of roentgenology (1976)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Choi, Ji Soo</au><au>Kim, Jinna</au><au>Kwak, Jin Young</au><au>Kim, Min Jung</au><au>Chang, Hang Seok</au><au>Kim, Eun-Kyung</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Preoperative Staging of Papillary Thyroid Carcinoma: Comparison of Ultrasound Imaging and CT</atitle><jtitle>American journal of roentgenology (1976)</jtitle><addtitle>AJR Am J Roentgenol</addtitle><date>2009-09-01</date><risdate>2009</risdate><volume>193</volume><issue>3</issue><spage>871</spage><epage>878</epage><pages>871-878</pages><issn>0361-803X</issn><eissn>1546-3141</eissn><coden>AAJRDX</coden><abstract>The purpose of this study was to compare the diagnostic accuracy of ultrasound imaging with that of CT in the preoperative evaluation of primary tumors and cervical lymph nodes in patients with papillary thyroid carcinoma and to determine whether CT has greater diagnostic value than ultrasound alone in the care of these patients.
The study population consisted of 299 consecutively registered patients with pathologically proven papillary thyroid carcinoma. The diagnostic accuracies of ultrasound, CT, and the combination of ultrasound and CT in the evaluation of primary tumors and lymph node metastasis were compared. We performed subgroup analysis to compare the findings on papillary thyroid microcarcinoma (10 mm in maximum diameter or smaller) with the findings on papillary thyroid carcinoma larger than 1 cm in maximum diameter.
Ultrasound was more accurate than CT in prediction of the presence of extrathyroidal tumor extension and of malignant disease in both thyroid lobes (p < 0.05) for overall lesions and for the two subgroups. In prediction of central node (neck level VI) metastasis, CT had greater sensitivity than ultrasound alone (p = 0.04) for overall lesions. Although the combination of ultrasound and CT had greater sensitivity than ultrasound alone in prediction of the presence of central node metastasis in the two subgroups, the sensitivity of the combination of ultrasound and CT did not reach statistical significance for papillary thyroid microcarcinoma. Ultrasound alone and ultrasound with CT had greater sensitivity than CT in prediction of lateral node (levels II-V) metastasis, but there was no significant difference in diagnostic value between ultrasound and the combination of ultrasound and CT for overall lesions or for the two subgroups (p > 0.05).
High-resolution ultrasound can be accurate in preoperative evaluation for extrathyroidal tumor extension and lateral lymph node metastasis. CT had greater sensitivity than ultrasound alone in the detection of central lymph node metastasis for all lesions. For papillary thyroid microcarcinoma, however, there was no significant difference in the diagnostic accuracy rates of ultrasound, CT, and the combination of ultrasound and CT.</abstract><cop>Reston, VA</cop><pub>Am Roentgen Ray Soc</pub><pmid>19696304</pmid><doi>10.2214/AJR.09.2386</doi><tpages>8</tpages></addata></record> |
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| ispartof | American journal of roentgenology (1976), 2009-09, Vol.193 (3), p.871-878 |
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| subjects | Adult Aged Biological and medical sciences Carcinoma, Papillary - diagnostic imaging Carcinoma, Papillary - pathology Carcinoma, Papillary - surgery Chi-Square Distribution Contrast Media Endocrinopathies Female Humans Image Interpretation, Computer-Assisted Investigative techniques, diagnostic techniques (general aspects) Iohexol - analogs & derivatives Lymphatic Metastasis - diagnostic imaging Lymphatic Metastasis - pathology Male Malignant tumors Medical sciences Middle Aged Miscellaneous. Technology Neoplasm Staging Non tumoral diseases. Target tissue resistance. Benign neoplasms Prospective Studies Thyroid Neoplasms - diagnostic imaging Thyroid Neoplasms - pathology Thyroid Neoplasms - surgery Thyroid. Thyroid axis (diseases) Tomography, X-Ray Computed Ultrasonic investigative techniques Ultrasonography |
| title | Preoperative Staging of Papillary Thyroid Carcinoma: Comparison of Ultrasound Imaging and CT |
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