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Shear wave elastography in evaluation of cervical lymph node metastasis of papillary thyroid carcinoma: elasticity index as a prognostic implication

 Woo Sang Jung  ;  Jeong-Ah Kim  ;  Eun Ju Son  ;  Ji Hyun Youk  ;  Cheong Soo Park 
 ANNALS OF SURGICAL ONCOLOGY, Vol.22(1) : 111-116, 2015 
Journal Title
Issue Date
Adult ; Carcinoma, Papillary/diagnostic imaging* ; Carcinoma, Papillary/secondary* ; Carcinoma, Papillary/surgery ; Elasticity Imaging Techniques/methods* ; Female ; Follow-Up Studies ; Humans ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Staging ; Prognosis ; Retrospective Studies ; Thyroid Neoplasms/diagnostic imaging* ; Thyroid Neoplasms/pathology* ; Thyroid Neoplasms/surgery ; Thyroidectomy
Papillary Thyroid Carcinoma ; Shear Wave Elastography ; Papillary Thyroid Carcinoma Patient ; Elasticity Index ; Extranodal Extension
PURPOSE: The aim of this study was to evaluate the usefulness of shear wave elastography (SWE) for predicting cervical lymph node (LN) metastasis and the prognostic implication of SWE as histopathologic factors of papillary thyroid carcinoma (PTC). METHODS: Eighty-four LNs of 66 patients with PTC underwent B-mode ultrasonography (BUS) and SWE before ultrasound-guided fine-needle aspiration biopsy or preoperative evaluation. SWE elasticity indices (EI) of mean (Emean), minimum (Emin), maximum (Emax) and the ratio of Emean in LNs and surrounding muscle (Emean-m) were measured at the stiffest portion of LNs (kPa). SWE EI were correlated with the pathologic diagnosis and the histopathologic findings, including number and size of metastatic LNs, the ratio of the number of metastatic LN/dissected LN, and the presence of extranodal extension. Diagnostic performances of SWE EI and BUS for predicting LN metastasis were assessed using receiver operating curve analysis. RESULTS: All SWE EI were significantly higher in metastatic LNs than in benign LNs (p < 0.005). Combined Emean [area under the curve (AUC) 0.811] or Emin (AUC 0.812) with BUS showed significantly higher AUC than BUS (0.738) for predicting metastatic LNs (p = 0.041 and 0.033, respectively). The number of positive LNs/dissected LNs and the largest LN size were significantly correlated with SWE EI (p < 0.05 and p < 0.005, respectively). Metastatic LNs with extranodal extension showed significantly higher SWE EI (p < 0.005) than those without extranodal extension. CONCLUSIONS: Combined use of SWE and BUS was adjunctive to the diagnostic performance of BUS for the prediction of LN metastasis of PTC, and quantitative SWE could predict pathologic prognostic factors of LN metastasis of PTC.
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1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Jeong Ah(김정아) ORCID logo https://orcid.org/0000-0003-4949-4913
Park, Cheong Soo(박정수)
Son, Eun Ju(손은주) ORCID logo https://orcid.org/0000-0002-7895-0335
Youk, Ji Hyun(육지현) ORCID logo https://orcid.org/0000-0002-7787-780X
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