Evaluation of cervical lymph node metastasis in thyroid cancer patients using real-time CT-navigated ultrasonography: preliminary study
Na Dae-Kwon, 최윤정, 최선형, 국신호, 박희진,
소속 상세정보
( Na Dae-Kwon )
Sungkyunkwan University School of Medicine Kangbuk Samsung Hospital Department of Radiology
최윤정 ( Choi Yoon-Jung )
Sungkyunkwan University School of Medicine Kangbuk Samsung Hospital Department of Radiology
최선형 ( Choi Seon-Hyeong )
Sungkyunkwan University School of Medicine Kangbuk Samsung Hospital Department of Radiology
국신호 ( Kook Shin-Ho )
Sungkyunkwan University School of Medicine Kangbuk Samsung Hospital Department of Radiology
박희진 ( Park Hee-Jin )
Sungkyunkwan University School of Medicine Kangbuk Samsung Hospital Department of Radiology
KMID : 1038420150340010039
Abstract
Purpose: To evaluate the diagnostic accuracy of real-time neck computed tomography (CT)-guided ultrasonography (US) in detecting cervical neck lymph node metastasis (LNM) in patients with papillary thyroid cancer (PTC).
Methods: We retrospectively reviewed data from 176 patients (mean age, 43 years; range, 23 to 74 years) with surgically confirmed PTC who underwent preoperative US, neck CT, and neck CTguided US. We then compared the sensitivities and diagnostic accuracies of each of the three above modalities in detecting cervical LNM.
Results: Preoperative US showed 17.3% sensitivity and 58.5% diagnostic accuracy in detecting central LNM compared with 64.3% sensitivity and 89.2% diagnostic accuracy in detecting lateral neck LNM. Neck CT showed 23.5% sensitivity and 55.7% diagnostic accuracy in detecting central LNM and 71.4% sensitivity with 90.9% diagnostic accuracy in detecting lateral neck LNM. CT-guided US exhibited 37.0% sensitivity and 63.1% diagnostic accuracy in detecting central LNM compared with 92.9% sensitivity and 96.0% diagnostic accuracy in detecting lateral LNM. CT-guided US showed higher diagnostic accuracy with superior sensitivity in detecting central and lateral LNM than did US (P<0.001, P=0.011) and CT (P=0.026, P=0.063).
Conclusion: Neck CT-guided US is a more accurate technique with higher sensitivity for detecting cervical LNM than either US or CT alone. Therefore, our data indicate that neck CT-guided US is an especially useful technique in preoperative examinations.
키워드
Thyroid cancer; papillary;Lymph nodes;Neoplasm metastasis;Ultrasonography;Multidetector computed tomography
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