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01-08-2016 | Head and Neck

Prediction of cervical lymph node metastasis in patients with papillary thyroid cancer using combined conventional ultrasound, strain elastography, and acoustic radiation force impulse (ARFI) elastography

Authors: Jun-Mei Xu, Xiao-Hong Xu, Hui-Xiong Xu, Yi-Feng Zhang, Le-Hang Guo, Lin-Na Liu, Chang Liu, Xiao-Wan Bo, Shen Qu, Mingzhao Xing, Xiao-Long Li

Published in: European Radiology | Issue 8/2016

Abstract

Objectives

To investigate the value of combined conventional ultrasound (US), strain elastography (SE) and acoustic radiation force impulse (ARFI) elastography for prediction of cervical lymph node metastasis (CLNM) in papillary thyroid cancer (PTC).

Methods

A consecutive series of 203 patients with 222 PTCs were preoperatively evaluated by US, SE, and ARFI including virtual touch tissue imaging (VTI) and virtual touch tissue quantification (VTQ). A multivariate analysis was performed to predict CLNM by 22 independent variables. Receiver operating characteristic (ROC) curve analysis was used to evaluate the diagnostic performance.

Results

Multivariate analysis demonstrated that VTI area ratio (VAR) > 1 was the best predictor for CLNM, followed by abnormal cervical lymph node (ACLN), capsule contact, microcalcification, capsule involvement, and multiple nodules (all P < 0.05). ROC analyses of these characteristics showed the areas under the curve (Az), sensitivity, and specificity were 0.600–0.630, 47.7 %–93.2 %, and 26.9 %–78.4 % for US, respectively; and they were 0.784, 83.0 %, and 73.9 %, respectively, for VAR > 1. As combination of US characteristics with and without VAR, the Az, sensitivity, and specificity were 0.803 and 0.556, 83.0 % and 100.0 %, and 77.6 % and 11.2 %, respectively (P < 0.001).

Conclusions

ARFI elastography shows superior performance over conventional US, particularly when combined with US, in predicting CLNM in PTC patients.

Key Points

• Conventional ultrasound is useful in predicting cervical lymph node metastasis preoperatively.

• Virtual touch tissue imaging area ratio is the strongest predicting factor.

• Predictive performance is markedly improved by combining ultrasound characteristics with VAR.

• Acoustic radiation force impulse elastography may be a promising complementary tool.

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Title: Prediction of cervical lymph node metastasis in patients with papillary thyroid cancer using combined conventional ultrasound, strain elastography, and acoustic radiation force impulse (ARFI) elastography
Authors: Jun-Mei Xu
Xiao-Hong Xu
Hui-Xiong Xu
Yi-Feng Zhang
Le-Hang Guo
Lin-Na Liu
Chang Liu
Xiao-Wan Bo
Shen Qu
Mingzhao Xing
Xiao-Long Li
Publication date: 01-08-2016
Publisher: Springer Berlin Heidelberg
Published in: European Radiology / Issue 8/2016
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-015-4088-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Prediction of cervical lymph node metastasis in patients with papillary thyroid cancer using combined conventional ultrasound, strain elastography, and acoustic radiation force impulse (ARFI) elastography

Abstract

Objectives

Methods

Results

Conclusions

Key Points

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusions

Key Points

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