We found a match
Your institution may have rights to this item. Sign in to continue.
- Title
Preoperative assessment of cervical lymph node metastases in patients with papillary thyroid carcinoma: Incremental diagnostic value of dual-energy CT combined with ultrasound.
- Authors
Yoon, Jimin; Choi, Yangsean; Jang, Jinhee; Shin, Na-Young; Ahn, Kook-Jin; Kim, Bum-soo
- Abstract
Purpose: To determine whether dual-energy CT (DECT) has incremental diagnostic value when combined with ultrasound (US) in the diagnosis of metastatic cervical lymph nodes (LNs) in patients with papillary thyroid carcinoma (PTC). Methods: This was a single-center retrospective cohort study of patients diagnosed with PTC between October 2019 and August 2020. US features of LNs to include hyperechogenicity, round shape, microcalcification, cystic component, and homogeneous/peripheral vascularity were considered suggestive of metastasis. The HU of arterial phase (HUarterial) and DECT-derived CT images [contrast media (CM) and areas under the 100 keV monoenergetic curve (AUC100keV)] were measured. Effective atomic numbers (Zeff), iodine concentration (mg/mL), and slope of the HU curve (λHU) were also obtained. The values for metastatic and benign LNs were compared using Student's t-test with false-discovery correction. Logistic regression with areas under the receiver operating characteristic curves (AUCs) were performed for predicting metastatic LNs. Results: A total of 102 patients were included (49 metastatic and 53 benign LNs; mean age, 46±15 years). Metastatic LNs showed significantly higher values for HUarterial, CM, Zeff, λHU, AUC100keV, and iodine concentration (all, P = 0.001). In logistic regression, the HUarterial demonstrated the highest AUC (0.824; 95% confidence interval [CI], 0.751–0.897), followed by CM HU (0.762; 95% CI, 0.679–0.846). Combination of DECT parameters with US features improved the AUC from 0.890 to 0.941. Conclusion: Compared to US features alone, combination with DECT-derived quantitative parameters improved diagnostic performance in predicting metastatic cervical LNs in patients with PTC.
- Subjects
LYMPHATIC metastasis; ULTRASONIC imaging; PAPILLARY carcinoma; THYROID cancer; COMPUTED tomography; DIAGNOSTIC ultrasonic imaging
- Publication
PLoS ONE, 2021, Vol 16, Issue 12, p1
- ISSN
1932-6203
- Publication type
Article
- DOI
10.1371/journal.pone.0261233