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Open Access 01-12-2021 | Computed Tomography | Research article

Prediction of ipsilateral lateral cervical lymph node metastasis in papillary thyroid carcinoma: a combined dual-energy CT and thyroid function indicators study

Authors: Ying Zou, Huanlei Zhang, Wenfei Li, Yu Guo, Fang Sun, Yan Shi, Yan Gong, Xiudi Lu, Wei Wang, Shuang Xia

Published in: BMC Cancer | Issue 1/2021

Abstract

Background

Predicting the possibility of ipsilateral lateral cervical lymph node metastasis (ipsi-LLNM) was crucial to the operation plan for patients with papillary thyroid carcinoma (PTC). This study aimed to investigate the independent risk factors for ipsi-LLNM in PTC patients by combining dual-energy computed tomography (DECT) with thyroid function indicators.

Methods

We retrospectively enrolled 406 patients with a pathological diagnosis of PTC from Jan 2016 to Dec 2019. Ensure the DECT images were clear and the thyroid function indicators were complete. Univariate and multivariate logistic analyses explored the independent risk factors for ipsi-LLNM. To evaluate the cutoff value of each risk factor by using receiver operating characteristic (ROC) curves.

Results

A total of 406 patients with PTC were analyzed, including 128 with ipsi-LLNM and 278 without ipsi-LLNM. There were statistical differences of parameters between the two groups (P < .0001), including serum Tg, Anti-Tg, Anti-TPO, the volume of the primary lesion, calcification, extrathyroidal extension (ETE), and iodine concentration (IC) in the arterial and the venous phases. Independent risk factors for ipsi-LLNM included serum Tg, Anti-Tg, ETE, and IC in the arterial and the venous phases (P < .05). The combined application of the above independent risk factors can predict the possibility of ipsi-LLNM, with an AUC of 0.834. Ipsi-LLNM was more likely to occur when the following conditions were met: with ETE, Tg > 100.01 ng/mL, Anti-Tg > 89.43 IU/mL, IC in arterial phase > 3.4 mg/mL and IC in venous phase > 3.1 mg/mL.

Conclusions

The combined application of DECT quantitative parameters and thyroid function indicators can help clinicians accurately predict ipsi-LLNM before surgery, thereby assisting the individualized formulation of surgical procedures.

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Title: Prediction of ipsilateral lateral cervical lymph node metastasis in papillary thyroid carcinoma: a combined dual-energy CT and thyroid function indicators study
Authors: Ying Zou
Huanlei Zhang
Wenfei Li
Yu Guo
Fang Sun
Yan Shi
Yan Gong
Xiudi Lu
Wei Wang
Shuang Xia
Publication date: 01-12-2021
Publisher: BioMed Central
Keywords: Computed Tomography
Hashimoto Thyroiditis
Metastasis
Computed Tomography
Published in: BMC Cancer / Issue 1/2021
Electronic ISSN: 1471-2407
DOI: https://doi.org/10.1186/s12885-021-07951-0

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