Ultrasonographic Differentiation of Cervical Lymph Nodes in Patients with Papillary Thyroid Carcinoma After Thyroidectomy and Radioiodine Ablation: A Prospective Study |
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| Institution: | 1. School of Metallurgy and Environment, Central South University, Changsha 410083, China;2. National Engineering Laboratory for Efficient Utilization of Refractory Non-ferrous Metals Resources, Changsha 410083, China;1. Harbin Institute of Technology Shenzhen Graduate School, ShenZhen, Guangdong 518055, China;2. Shenzhen Applied Technology Engineering Laboratory for Internet Multimedia Application, ShenZhen, Guangdong 518055, China;3. Public Service Platform of Mobile Internet Application Security Industry, ShenZhen, Guangdong 518055, China;4. School of Computing, National University of Singapore, 117417 Singapore;1. Interdisziplinäre Endokrinologie, Diabetologie und Neurochirurgie, Universitätsklinikum Hamburg-Eppendorf,;2. Institut für Pathologie, Universitätsklinikum Hamburg-Eppendorf;3. Klinik und Poliklinik für Nuklearmedizin, Zentrum für Radiologie und Endoskopie, Hamburg, Germany.;1. Department of Architecture and Architectural Engineering, Kyoto University, Kyoto-Daigaku Katsura, Nishikyo, Kyoto 615-8540, Japan;2. Department of Architecture, Tokyo University of Science, Tokyo 125-8585, Japan;3. School of Civil Engineering, Chongqing University, Chongqing 400045, China |
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| Abstract: | ObjectiveThe objective of the present study was to validate an ultrasound (US) classification of cervical lymph nodes (LNs) in patients with papillary thyroid cancer (PTC) after thyroidectomy and radioactive iodine (131I) ablation.MethodsWe performed a prospective study in which the patients were submitted to thyroidectomy and 131I ablation and then followed until neck US revealed LN(s) ≥ 5 mm. A total of 288 LNs from 112 patients with PTC were evaluated. Patient management was based on LN characteristics grouped according to the classification system studied here.ResultsThe presence of microcalcifications and/or cystic degeneration of cervical LNs were highly suggestive of a metastatic etiology (specificity of 99.4%). In contrast, the most sensitive finding for LNs affected by PTC was the absence of an echogenic hilum (sensitivity of 100%). In the absence of these findings (microcalcifications, cystic degeneration, echogenic hilum), a metastatic etiology was the most likely in the case of a round LN (specificity of 89%). The differentiation of a spindle-shaped LN without a visible hilum by Doppler analysis permitted us to dichotomize an initial probability of metastases of 13% in 25% (with peripheral vascularization) versus 3.3% (without peripheral vascularization).ConclusionsOur results confirm that the classification proposed for cervical LNs in patients with PTC is valid for determining patient management following initial therapy. (Endocr Pract. 2014;20:293-298) |
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