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The Diagnostic Utility of Ultrasonography, CT and PET/CT for the Preoperative Evaluation of Cervical Lymph Node Metastasis in Papillary Thyroid Cancer Patients
±è¿µ»ó, ÀÌÅÂÇö, ¹Úµ¿Èñ,
¼Ò¼Ó »ó¼¼Á¤º¸
±è¿µ»ó ( Kim Young-Sang )
Çѱ¹¿øÀÚ·ÂÀÇÇпø ¿øÀڷº´¿ø ¿µ»óÀÇÇаú
ÀÌÅÂÇö ( Lee Tae-Hyun )
Çѱ¹¿øÀÚ·ÂÀÇÇпø ¿øÀڷº´¿ø ¿µ»óÀÇÇаú
¹Úµ¿Èñ ( Park Dong-Hee )
Çѱ¹¿øÀÚ·ÂÀÇÇпø ¿øÀڷº´¿ø ¿µ»óÀÇÇаú
KMID : 1103720160750020104
Abstract
¸ñÀû: À¯µÎ°©»ó»ù¾ÏÁ¾ ȯÀÚÀÇ °æºÎ ¸²ÇÁÀý ÀüÀÌ Áø´ÜÀ» À§ÇÑ ÃÊÀ½ÆÄ(ultrasonography; ÀÌÇÏ US)¿Í Àü»êÈ´ÜÃþÃÔ¿µ(CT), ¾çÀüÀÚ¹æÃâ´ÜÃþÃÔ¿µ(positron emission tomography/CT; ÀÌÇÏ PET/CT)ÀÇ Áø´ÜÀû À¯¿ë¼ºÀ» ¾Ë¾Æº¸°íÀÚ ÇÏ¿´´Ù.
´ë»ó°ú ¹æ¹ý: À¯µÎ°©»ó»ù¾ÏÁ¾À¸·Î °©»ó¼± ÀýÁ¦¼ú ¹× °æºÎ ¸²ÇÁÀý ÀýÁ¦¼úÀ» ¹ÞÀº ȯÀÚ 300¸íÀ» ´ë»óÀ¸·Î ÈÄÇâÀû ¿¬±¸¸¦ ½ÃÇàÇÏ¿´´Ù. ¼ö¼ú Àü °æºÎ US¿Í CT ¹× PET/CT¸¦ ½ÃÇàÇÑ °á°ú¸¦ ¼ö¼ú ÈÄ ¾òÀº Á¶Á÷º´¸® °Ë»ç°á°ú¿Í ºñ±³ÇÏ¿© °æºÎ ¸²ÇÁÀý ÀüÀ̸¦ Æò°¡ÇÏ¿´´Ù.
°á°ú: Á߽ɰæºÎ ¸²ÇÁÀý ÀüÀÌ¿¡ ´ëÇÑ ¹Î°¨µµ(US 29.9%, CT 27.9%, PET/CT 18.8%)´Â Ãø°æºÎ ¸²ÇÁÀý ÀüÀÌ¿¡ ´ëÇÑ ¹Î°¨µµ(US 56.3%, CT 66.2%, PET/CT 43.7%)º¸´Ù ³·¾ÒÀ¸¸ç, ƯÀ̵µµµ Á߽ɰæºÎ ¸²ÇÁÀý(80.6%, 77.7%, 83.0%)ÀÌ Ãø°æºÎ ¸²ÇÁÀý(96.8%, 80.6%, 95.2%)º¸´Ù ³·¾Ò´Ù. Á߽ɰæºÎ ¸²ÇÁÀýÀ̳ª Ãø°æºÎ ¸²ÇÁÀý ¸ðµÎ US¿Í CT¸¦ ÇÔ²² ½ÃÇàÇϸé, US¸¦ ´Üµ¶À¸·Î ½ÃÇàÇßÀ» ¶§º¸´Ù ¹Î°¨µµ´Â »ó½ÂÇÏ°í ƯÀ̵µ´Â °¨¼ÒÇÏ¿´À¸¸ç, PET/CT¸¦ Ãß°¡·Î ½ÃÇàÇÏ´Â °ÍÀº Åë°èÇÐÀûÀ¸·Î À¯ÀǹÌÇÑ Â÷ÀÌ°¡ ¾ø¾ú´Ù.
°á·Ð: À¯µÎ°©»ó»ù¾ÏÁ¾ ȯÀÚ¿¡¼ US¿Í CT ¹× PET/CT´Â Á߽ɰæºÎ ¸²ÇÁÀýº¸´Ù Ãø°æºÎ ¸²ÇÁÀý¿¡¼ Á» ´õ °æºÎ ¸²ÇÁÀý ÀüÀÌÀÇ Æò°¡¿¡ À¯¿ëÇÏ°Ô »ç¿ëµÉ ¼ö ÀÖ´Ù. ¶ÇÇÑ US¿Í CT¸¦ µ¿½Ã¿¡ ½ÃÇàÇϸé US¸¦ ´Üµ¶À¸·Î ½ÃÇàÇßÀ» ¶§º¸´Ù ¹Î°¨µµ¸¦ ³ôÀϼö ÀÖ´Ù.
Purpose: To compare the diagnostic utility of ultrasonography (US), CT and positron emission tomography/CT (PET/CT) in the preoperative evaluation of cervical lymph node metastasis in patients with papillary thyroid carcinoma.
Materials and Methods: The study population consisted of 300 patients with pathologically diagnosed papillary thyroid carcinoma after thyroidectomy and neck dissection. Preoperative US, CT, and PET/CT findings were compared with pathologic outcomes after thyroidectomy and neck dissection.
Results: Sensitivity in detecting central lymph node metastasis (US 29.9%, CT 27.9%, PET/CT 18.8%) was lower than that for lateral lymph node metastasis (US 56.3%, CT 66.2%, PET/CT 43.7%). Specificity in detecting central lymph node metastasis (US 80.6%, CT 77.7%, PET/CT 83.0%) was lower than that for lateral lymph node metastasis (US 96.8%, CT 80.6%, PET/CT 95.2%). The combination of US and CT had higher specificity (77.3%) and higher sensitivity (33.1%) than US alone. PET/CT has no significant additional benefit over the combination of US and CT.
Conclusion: In preoperative evaluations of neck lymph node metastasis, US and CT and PET/CT are more useful in lateral lymph node areas than in central lymph node areas. The combination of US and CT has higher sensitivity than US alone.
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Thyroid Gland; Carcinoma; Papillary; Ultrasonography; Tomography; X-Ray Computed; Positron-Emission Tomography
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