Journal
EUROPEAN RADIOLOGY
Volume 26, Issue 8, Pages 2611-2622Publisher
SPRINGER
DOI: 10.1007/s00330-015-4088-2
Keywords
Thyroid nodule; Thyroid cancer; Acoustic radiation force impulse; Virtual touch tissue imaging; Conventional ultrasound
Funding
- Shanghai Hospital Development Center [SHDC12014229]
- Science and Technology Commission of Shanghai Municipality [14441900900, 15411969000]
- Shanghai Municipal Human Resources and Social Security Bureau [2012045]
- National Natural Science Foundation of China [81501475, 81401417, 81472579]
Ask authors/readers for more resources
To investigate the value of combined conventional ultrasound (US), strain elastography (SE) and acoustic radiation force impulse (ARFI) elastography for prediction of cervical lymph node metastasis (CLNM) in papillary thyroid cancer (PTC). A consecutive series of 203 patients with 222 PTCs were preoperatively evaluated by US, SE, and ARFI including virtual touch tissue imaging (VTI) and virtual touch tissue quantification (VTQ). A multivariate analysis was performed to predict CLNM by 22 independent variables. Receiver operating characteristic (ROC) curve analysis was used to evaluate the diagnostic performance. Multivariate analysis demonstrated that VTI area ratio (VAR) > 1 was the best predictor for CLNM, followed by abnormal cervical lymph node (ACLN), capsule contact, microcalcification, capsule involvement, and multiple nodules (all P < 0.05). ROC analyses of these characteristics showed the areas under the curve (Az), sensitivity, and specificity were 0.600-0.630, 47.7 %-93.2 %, and 26.9 %-78.4 % for US, respectively; and they were 0.784, 83.0 %, and 73.9 %, respectively, for VAR > 1. As combination of US characteristics with and without VAR, the Az, sensitivity, and specificity were 0.803 and 0.556, 83.0 % and 100.0 %, and 77.6 % and 11.2 %, respectively (P < 0.001). ARFI elastography shows superior performance over conventional US, particularly when combined with US, in predicting CLNM in PTC patients. Conventional ultrasound is useful in predicting cervical lymph node metastasis preoperatively. Virtual touch tissue imaging area ratio is the strongest predicting factor. Predictive performance is markedly improved by combining ultrasound characteristics with VAR. Acoustic radiation force impulse elastography may be a promising complementary tool.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available