Preoperative assessment of cervical lymph node metastases in patients with papillary thyroid carcinoma: Incremental diagnostic value of dual-energy CT combined with ultrasound.
<h4>Purpose</h4>To determine whether dual-energy CT (DECT) has incremental diagnostic value when combined with ultrasound (US) in the diagnosis of metastatic cervical lymph nodes (LNs) in patients with papillary thyroid carcinoma (PTC).<h4>Methods</h4>This was a single-center...
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Public Library of Science (PLoS)
2021-01-01
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| Online Access: | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0261233&type=printable |
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| author | Jimin Yoon Yangsean Choi Jinhee Jang Na-Young Shin Kook-Jin Ahn Bum-Soo Kim |
| author_facet | Jimin Yoon Yangsean Choi Jinhee Jang Na-Young Shin Kook-Jin Ahn Bum-Soo Kim |
| author_sort | Jimin Yoon |
| collection | DOAJ |
| description | <h4>Purpose</h4>To determine whether dual-energy CT (DECT) has incremental diagnostic value when combined with ultrasound (US) in the diagnosis of metastatic cervical lymph nodes (LNs) in patients with papillary thyroid carcinoma (PTC).<h4>Methods</h4>This was a single-center retrospective cohort study of patients diagnosed with PTC between October 2019 and August 2020. US features of LNs to include hyperechogenicity, round shape, microcalcification, cystic component, and homogeneous/peripheral vascularity were considered suggestive of metastasis. The HU of arterial phase (HUarterial) and DECT-derived CT images [contrast media (CM) and areas under the 100 keV monoenergetic curve (AUC100keV)] were measured. Effective atomic numbers (Zeff), iodine concentration (mg/mL), and slope of the HU curve (λHU) were also obtained. The values for metastatic and benign LNs were compared using Student's t-test with false-discovery correction. Logistic regression with areas under the receiver operating characteristic curves (AUCs) were performed for predicting metastatic LNs.<h4>Results</h4>A total of 102 patients were included (49 metastatic and 53 benign LNs; mean age, 46±15 years). Metastatic LNs showed significantly higher values for HUarterial, CM, Zeff, λHU, AUC100keV, and iodine concentration (all, P = 0.001). In logistic regression, the HUarterial demonstrated the highest AUC (0.824; 95% confidence interval [CI], 0.751-0.897), followed by CM HU (0.762; 95% CI, 0.679-0.846). Combination of DECT parameters with US features improved the AUC from 0.890 to 0.941.<h4>Conclusion</h4>Compared to US features alone, combination with DECT-derived quantitative parameters improved diagnostic performance in predicting metastatic cervical LNs in patients with PTC. |
| format | Article |
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| institution | OA Journals |
| issn | 1932-6203 |
| language | English |
| publishDate | 2021-01-01 |
| publisher | Public Library of Science (PLoS) |
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| series | PLoS ONE |
| spelling | doaj-art-49df9fd47dda44dda1d05c868ac36f212025-08-20T02:17:56ZengPublic Library of Science (PLoS)PLoS ONE1932-62032021-01-011612e026123310.1371/journal.pone.0261233Preoperative assessment of cervical lymph node metastases in patients with papillary thyroid carcinoma: Incremental diagnostic value of dual-energy CT combined with ultrasound.Jimin YoonYangsean ChoiJinhee JangNa-Young ShinKook-Jin AhnBum-Soo Kim<h4>Purpose</h4>To determine whether dual-energy CT (DECT) has incremental diagnostic value when combined with ultrasound (US) in the diagnosis of metastatic cervical lymph nodes (LNs) in patients with papillary thyroid carcinoma (PTC).<h4>Methods</h4>This was a single-center retrospective cohort study of patients diagnosed with PTC between October 2019 and August 2020. US features of LNs to include hyperechogenicity, round shape, microcalcification, cystic component, and homogeneous/peripheral vascularity were considered suggestive of metastasis. The HU of arterial phase (HUarterial) and DECT-derived CT images [contrast media (CM) and areas under the 100 keV monoenergetic curve (AUC100keV)] were measured. Effective atomic numbers (Zeff), iodine concentration (mg/mL), and slope of the HU curve (λHU) were also obtained. The values for metastatic and benign LNs were compared using Student's t-test with false-discovery correction. Logistic regression with areas under the receiver operating characteristic curves (AUCs) were performed for predicting metastatic LNs.<h4>Results</h4>A total of 102 patients were included (49 metastatic and 53 benign LNs; mean age, 46±15 years). Metastatic LNs showed significantly higher values for HUarterial, CM, Zeff, λHU, AUC100keV, and iodine concentration (all, P = 0.001). In logistic regression, the HUarterial demonstrated the highest AUC (0.824; 95% confidence interval [CI], 0.751-0.897), followed by CM HU (0.762; 95% CI, 0.679-0.846). Combination of DECT parameters with US features improved the AUC from 0.890 to 0.941.<h4>Conclusion</h4>Compared to US features alone, combination with DECT-derived quantitative parameters improved diagnostic performance in predicting metastatic cervical LNs in patients with PTC.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0261233&type=printable |
| spellingShingle | Jimin Yoon Yangsean Choi Jinhee Jang Na-Young Shin Kook-Jin Ahn Bum-Soo Kim Preoperative assessment of cervical lymph node metastases in patients with papillary thyroid carcinoma: Incremental diagnostic value of dual-energy CT combined with ultrasound. PLoS ONE |
| title | Preoperative assessment of cervical lymph node metastases in patients with papillary thyroid carcinoma: Incremental diagnostic value of dual-energy CT combined with ultrasound. |
| title_full | Preoperative assessment of cervical lymph node metastases in patients with papillary thyroid carcinoma: Incremental diagnostic value of dual-energy CT combined with ultrasound. |
| title_fullStr | Preoperative assessment of cervical lymph node metastases in patients with papillary thyroid carcinoma: Incremental diagnostic value of dual-energy CT combined with ultrasound. |
| title_full_unstemmed | Preoperative assessment of cervical lymph node metastases in patients with papillary thyroid carcinoma: Incremental diagnostic value of dual-energy CT combined with ultrasound. |
| title_short | Preoperative assessment of cervical lymph node metastases in patients with papillary thyroid carcinoma: Incremental diagnostic value of dual-energy CT combined with ultrasound. |
| title_sort | preoperative assessment of cervical lymph node metastases in patients with papillary thyroid carcinoma incremental diagnostic value of dual energy ct combined with ultrasound |
| url | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0261233&type=printable |
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