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Short-term Follow-up US Leads to Higher False-positive Results Without Detection of Structural Recurrences in PTMC

 Jung Hyun Yoon  ;  Hye Sun Lee  ;  Eun-Kyung Kim  ;  Ji Hyun Youk  ;  Hyun Gi Kim  ;  Hee Jung Moon  ;  Jin Young Kwak 
 MEDICINE, Vol.95(1) : 2435, 2016 
Journal Title
Issue Date
Ablation Techniques/methods ; Adult ; Carcinoma, Papillary/diagnostic imaging* ; Carcinoma, Papillary/pathology ; Carcinoma, Papillary/surgery ; False Positive Reactions ; Female ; Humans ; Iodine Radioisotopes/therapeutic use ; Lymphatic Metastasis ; Male ; Middle Aged ; Neck/diagnostic imaging* ; Retrospective Studies ; Thyroid Neoplasms/diagnostic imaging* ; Thyroid Neoplasms/pathology ; Thyroid Neoplasms/surgery ; Thyroidectomy/methods ; Time Factors ; Ultrasonography
To investigate the value of the annual follow-up neck ultrasonography (US) for postoperative surveillance in patients with papillary thyroid microcarcinoma (PTMC). This retrospective study has been approved by our institutional review board (IRB) with waiver for informed consent. A total of 375 patients diagnosed as PTMCs, who underwent total thyroidectomy with radioiodine remnant ablation were included, to identify the recurrence rate and the false-positive rate of annual ultrasound. The number, interval, and the results of follow-up US or fine needle aspiration were obtained from electronic medical records. Four (1.1%, 4/375) recurrences were found 3 years after the initial treatment, and only 1 patient (0.3%, 1/375) had a metastatic lymph node larger than 8 mm in the shortest diameter on US found 7.6 years after initial treatment with biochemical abnormalities. Cumulative risk of having at least 1 false-positive exam was 8.3% by the 8th US, and 8.1% by the 8-9 year follow-up. Cox multivariate regression showed shorter interval of follow-up US and presence of lymph node metastasis at initial surgery are independent predictors affecting the cumulative false-positive results (hazard ratio [HR], 0.60; 95% confidence interval [CI]: 0.49-0.73; P < 0.001 and HR, 2.19; 95% CI: 1.01-4.75; P = 0.048, respectively). Short-term follow-up US can result in higher cumulative false-positive results without detection of meaningful recurrences in patients with PTMCs who do not have biochemical abnormalities.
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1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Yonsei Biomedical Research Center (연세의생명연구원) > 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
Moon, Hee Jung(문희정) ORCID logo https://orcid.org/0000-0002-5643-5885
Youk, Ji Hyun(육지현) ORCID logo https://orcid.org/0000-0002-7787-780X
Yoon, Jung Hyun(윤정현) ORCID logo https://orcid.org/0000-0002-2100-3513
Lee, Hye Sun(이혜선) ORCID logo https://orcid.org/0000-0001-6328-6948
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