The optimal selection of B-ultrasound,dual-energy computed tomography,and fine-needle aspiration for preoperative prediction of lymph node metastases in papillary thyroid carcinoma
LI Lin
ZHANG Lijun
SI Yan
SHEN Meiping
Abstract：Objective To determine the best preoperative diagnostic method for lymph node metastasis(LNM)in thyroid cancer by comparing high-resolution ultrasonography(US),dual-energy computed tomography(DECT),and fine-needle aspiration biopsy(FNAB).Methods The data of 1,174 papillary thyroid carcinoma(PTC)patients treated surgically at the First Affiliated Hospital of Nanjing Medical University was retrospectively analyzed.All patients were assessed preoperatively using US and DECT;One hundred and sixty-seven patients also underwent FNAB with thyroglobulin(TG)testing in washout fluid for LNM evaluation.Postoperative pathology was the diagnostic"gold standard"for assessing the best method to evaluate PTC LNM.Results DECT had a higher sensitivity for predicting LNM than US(55.4％vs 44.8％,P＜0.001),albeit with lower specificity(42.7％vs 72.7％,P＜0.001).When combined together,US and DECT's diagnostic accuracy for CLNM and LLNM varied:higher when findings are consistent but substantially lower when results are inconsistent(75.5％vs.63.4％,P＜0.001).At this time,the accuracy of FNAB and FNA-TG testing in suspicious lymph nodes increased to 87.9％.Conclusions Combining US and DECT is necessary for LNM evaluation;When the combined diagnosis has metastasis,no additional examination is required.When the combined diagnosis results are inconsistent,further FNAB and FNA-TG detection of lymph nodes are required to avoid unnecessary lateral dissection.
Keywords：Papillary thyroid carcinomaHigh-resolution ultrasonographyDual-energy computed tomographyFine-needle aspiration biopsyLymph node metastasis
Publication Date：2024-06-20
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 266-270 )