Adding CT to Ultrasonography for Lymph Node Characterization in Thyroid Cancer
Posted: Tuesday, July 28, 2020
According to a recent study published in Cancers, adding CT to standard ultrasonography imaging may help to detect metastasis of thyroid cancer in patients with ultrasonography-indeterminate lymph nodes. However, Sun-Won Park, MD, PhD, of the Seoul National University College of Medicine, Korea, and colleagues explained that a larger prospective study is needed to confirm these findings.
“Accurate preoperative imaging diagnosis of lymph node metastasis has been considered key to reducing the chance of repetitive surgery and operation-related morbidity,” the investigators commented. “The addition of CT to ultrasonography has the potential to be of value by suggesting the level of diagnostic confidence for the suspicious category according to the concordance of ultrasonography and CT studies, and by helping correctly detect metastasis in ultrasonography-indeterminate lymph nodes.”
A total of 225 patients with primary thyroid cancer who underwent a fine-needle aspiration or core-needle biopsy for neck lesions between December 2006 and June 2015 were enrolled in the study. The investigators identified 274 lesions within this patient population; each lesion was classified as probably benign, indeterminate, or suspicious based on the results of ultrasonography, CT, and combined ultrasonography and CT imaging. In each category, the malignancy risks were assessed and compared with concordant and discordant cases identified by combined ultrasonography and CT imaging.
According to ultrasonography, CT, and combined ultrasonography and CT imaging results, malignancy risks were, respectively, determined for each category: 1.7%, 8.7%, and 0% for the probably benign cases; 22.4%, 5.9%, and 8% for the indeterminate cases; 77.2%, 82%, and 75.6% for the suspicious cases. The malignancy risks of the concordant and discordant suspicious categories were 84.7% versus 43.2%, respectively (P < .001). After CT imaging, additional metastasis was detected in 16.4% of the ultrasonography-indeterminate cases and in 1.7% of the ultrasonography–probably benign cases.
Disclosure: The study authors reported no conflicts of interest.