Quantitative parameters of contrast-enhanced ultrasound effectively promote the prediction of cervical lymph node metastasis in papillary thyroid carcinoma

Biao Su; Lisha Li; Yingchun Liu; Hui Liu; Jia Zhan; Qiliang Chai; Liang Fang; Ling Wang; Lin Chen

doi:10.5582/ddt.2023.01095

Original Article

Quantitative parameters of contrast-enhanced ultrasound effectively promote the prediction of cervical lymph node metastasis in papillary thyroid carcinoma

Biao Su, Lisha Li, Yingchun Liu, Hui Liu, Jia Zhan, Qiliang Chai, Liang Fang, Ling Wang, Lin Chen

Author information

Biao Su
Department of Ultrasound, Huadong Hospital, Fudan University, Shanghai, China.
Department of Ultrasound, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
Lisha Li
Department of Reproductive Immunology, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China.
Shanghai Key Laboratory of Clinical Geriatric Medicine, Shanghai, China.
Yingchun Liu
Department of Ultrasound, Huadong Hospital, Fudan University, Shanghai, China.
Hui Liu
Department of Ultrasound, Huadong Hospital, Fudan University, Shanghai, China.
Department of Ultrasound, Shanghai Cancer Center, Fudan University, Shanghai, China.
Jia Zhan
Department of Ultrasound, Huadong Hospital, Fudan University, Shanghai, China.
Qiliang Chai
Department of Ultrasound, Huadong Hospital, Fudan University, Shanghai, China.
Liang Fang
Department of Ultrasound, Huadong Hospital, Fudan University, Shanghai, China.
Ling Wang
Department of Reproductive Immunology, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China.
Shanghai Key Laboratory of Clinical Geriatric Medicine, Shanghai, China.
Lin Chen
Department of Ultrasound, Huadong Hospital, Fudan University, Shanghai, China.

Keywords: contrast-enhanced ultrasound, quantitative parameter, papillary thyroid carcinoma, cervical lymph node metastasis

JOURNAL FREE ACCESS

2024 Volume 18 Issue 1 Pages 44-53

DOI https://doi.org/10.5582/ddt.2023.01095

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Abstract

Papillary thyroid carcinoma (PTC), the most common endocrine tumor, often spreads to cervical lymph nodes metastasis (CLNM). Preoperative diagnosis of CLNM is important when selecting surgical strategies. Therefore, we aimed to explore the effectiveness of quantitative parameters of contrast-enhanced ultrasound (CEUS) in predicting CLNM in PTC. We retrospectively analyzed 193 patients with PTC undergoing conventional ultrasound (CUS) and CEUS. The CUS features and quantitative parameters of CEUS were evaluated according to PTC size ≤ 10 or > 10 mm, using pathology as the gold standard. For the PTC ≤ 10 mm, microcalcification and multifocality were significantly different between the CLNM (+) and CLNM (-) groups (both P < 0.05). For the PTC > 10 mm, statistical significance was noted between the two groups with respect to the margin, capsule contact, and multifocality (all P < 0.05). For PTC ≤ 10 mm, there was no significant difference between the CLNM (+) and CLNM (-) groups in all quantitative parameters of CEUS (all P > 0.05). However, for PTC > 10 mm, the peak intensity (PI), mean transit time, and slope were significantly associated with CLNM (all P < 0.05). Multivariate analysis showed that PI > 5.8 dB was an independent risk factor for predicting CLNM in patients with PTC > 10 mm (P < 0.05). The area under the curve of PI combined with CUS (0.831) was significantly higher than that of CUS (0.707) or PI (0.703) alone in the receiver operator characteristic curve analysis (P < 0.05). In conclusion, PI has significance in predicting CLNM for PTC > 10 mm; however, it is not helpful for PTC ≤ 10 mm.

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