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Positive predictive value and interobserver variability of preoperative staging sonography for thyroid carcinoma

Authors
 Hee Jung Moon  ;  Jung Hyun Yoon  ;  Jin Young Kwak  ;  Woong Youn Chung  ;  Kee-Hyun Nam  ;  Jong Ju Jeong  ;  Eun-Kyung Kim 
Citation
 AMERICAN JOURNAL OF ROENTGENOLOGY, Vol.197(2) : 324-330, 2011 
Journal Title
AMERICAN JOURNAL OF ROENTGENOLOGY
ISSN
 0361-803X 
Issue Date
2011
MeSH
Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Neoplasm Staging ; Observer Variation ; Predictive Value of Tests ; Preoperative Care ; Prospective Studies ; Thyroid Neoplasms/diagnostic imaging* ; Thyroid Neoplasms/pathology ; Thyroid Neoplasms/surgery ; Ultrasonography
Keywords
sonography ; stage ; surgery ; thyroid carcinoma
Abstract
OBJECTIVE: The purpose of this article is to evaluate the positive predictive value (PPV) and interobserver variability of preoperative staging sonography for thyroid carcinoma.

SUBJECTS AND METHODS: Eighty-five patients (median age, 45 years) were included. The T and N staging were classified according to TNM classification. Extrathyroidal extension was defined as contact with the capsule greater than 25% of the perimeter of a malignant lesion or loss of the capsule line. The sonography criteria for lymph node metastases were absence of echogenic fatty hilum, round shape, hyperechogenicity, microcalcifications, cystic change, and peripheral vascularity. The PPV and interobserver variability of two radiologists were calculated.

RESULTS: The mean size of 85 malignancies was 8.6 mm, with 17 that were larger than 10 mm and 68 that were 10 mm or smaller. PPV ranges of sonography by two radiologists were 65-100% for T staging, 44.4-45.5% for multifocality, 71.4-81.8% for bilaterality, 28.6-80% for N1a staging, and 40-100% for N1b staging. In all malignancies, the kappa values were 0.5319 for T staging, 0.7741 for multifocality, 0.8604 for bilaterality, and 0.6793 for N staging. In 17 malignancies larger than 10 mm, the corresponding kappa values were lower (κ = 0.4516, 0.5952, 0.8211, and 0.6364, respectively). In 68 malignancies 10 mm or smaller, the corresponding kappa values showed slight improvements, except for T staging (κ = 0.5016, 0.8413, 0.8721, and 0.6821, respectively).

CONCLUSION: The T staging, bilaterality, and N1b staging of preoperative staging sonography showed high PPV. Agreements for T and N staging, multifocality, and bilaterality were moderate, substantial, substantial, and excellent, respectively.
Full Text
http://www.ajronline.org/doi/abs/10.2214/AJR.10.5576
DOI
10.2214/AJR.10.5576
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kwak, Jin Young(곽진영) ORCID logo https://orcid.org/0000-0002-6212-1495
Kim, Eun-Kyung(김은경) ORCID logo https://orcid.org/0000-0002-3368-5013
Nam, Kee Hyun(남기현) ORCID logo https://orcid.org/0000-0002-6852-1190
Moon, Hee Jung(문희정) ORCID logo https://orcid.org/0000-0002-5643-5885
Yoon, Jung Hyun(윤정현) ORCID logo https://orcid.org/0000-0002-2100-3513
Chung, Woong Youn(정웅윤)
Jeong, Jong Ju(정종주) ORCID logo https://orcid.org/0000-0002-4155-6035
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/93435
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