Younghen Lee MD, Presenter: Nothing to Disclose

Ji-hoon Kim MD, Abstract Co-Author: Nothing to Disclose

Dong Gyu Na MD, Abstract Co-Author: Nothing to Disclose

Jung Hwan Baek, Abstract Co-Author: Nothing to Disclose

Sun Won Park, Abstract Co-Author: Nothing to Disclose

So Lyung Jung, Abstract Co-Author: Nothing to Disclose

Eun Ju Ha, Abstract Co-Author: Nothing to Disclose

Jinna Kim MD, Abstract Co-Author: Nothing to Disclose

Tae Jin Yoon MD, Abstract Co-Author: Nothing to Disclose

To determine an additional diagnostic role of combined US/CT over the US evaluation for detection of metastatic LNs in patients with thyroid cancers.

During the recent 1 year, 9 experienced head and neck radiologists in seven institutions prospectively evaluated the both I~VI neck LN levels of patients with thyroid cancers prior to operation using both ultrasound (US) and contrast-enhanced neck CT. Imaging criteria of probably metastatic LN were as followed [US: calcification, cystic change, hyperechoic, abnormal vascular pattern; [CT]: calcification, cystic change, strong enhancement without hilar vessel, heterogeneous enhancement. If at least one of above mentioned criteria to suggest probably metastatic were found, we considered the corresponding LN level as probably metastatic. Finally, we enrolled pathologically proven 801 nodal levels (benign: malignant=418: 383; central: lateral: others =531:263: 7) from 353 patients (M:F=77:276, mean age: 47.0±12.3 years) with thyroid cancer (mean size: 13.5 ±10.5mm). Based on their pathologic results, the diagnostic performances of US, and combined US/CT classifications were compared by Mcnemar test.

Our level by level and patient-based analysis revealed that combined US/CT imaging criteria significantly improved the sensitivities (p<0.01), and decreased the specificities (p<0.01), while not affected the diagnostic accuracies (p>0.05) in the overall, central and lateral neck levels, compared to US-only, except the more higher diagnostic accuracies achieved only in lateral neck by combined US/CT criteria (p=0.011). Moreover, the sensitivities of CT criteria to detect additional metastatic LNs in lateral neck were 54.8% (23/42 levels) and 65.5% (19/29 persons) in cases of LNs which were not considered as probably metastatic by US criteria.

For preoperative neck LN evaluation, US/CT combined evaluation could play additional diagnostic roles in patients with thyroid cancers, especially in lateral neck, compared to US-based evaluation.

For preoperative neck LN evaluation, US/CT combined evaluation could play additional diagnostic roles in patients with thyroid cancers, especially in lateral neck, compared to US-based evaluation.

Lee, Y, Kim, J, Na, D, Baek, J, Park, S, Jung, S, Ha, E, Kim, J, Yoon, T, Could Contrast-enhanced CT Examination Add Diagnostic Value over US-based Detection of Metastatic Neck Lymph Nodes in Patients with Thyroid Cancer?: A Prospective, Multicenter Study. Korean Society of Thyroid Radiology (KSThR) Study Group.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14009113.html