2045: Preoperative evaluation of lymph node metastasis of thyroid cancer using real-time tissue elastography

Abstract

Objectives: The aim of this study was to investigate the clinical usefulness in detection of lymph node (LN) metastasis of thyroid cancer on real-time tissue elastography (RTE).Methods: Sixty cases were examined by RTE before surgery and those images were evaluated and classified into four patterns. Pattern 1: almost whole nodule displayed in light green. Pattern 2: light green base with blue in the periphery of the nodule. Pattern 3: blue zone base mixed with light green and red. Pattern 4: almost whole blue in the nodule. They were compared to pathological results.Results: Surgical LN dissections were performed in 78 lesions at lateral cervical areas and in 92 lesions at paratracheal areas. In 78 lateral cervical lesions, 58 (74%) lesions were detectable on B-mode and 64 (82%) lesions on RTE. In 92 paratracheal lesions, 35 (38%) lesions were detectable on B-mode and 30 (33%) lesions on RTE. Detection of LN metastasis at lateral cervical areas was improved by RTE.Conclusions: RTE demonstrated possibility of improvement in LN metastasis detection at lateral cervical areas. Though there are still some difficulties at paratracheal areas detection because of its anatomical features, RTE can provide useful information for surgical strategy. Objectives: The aim of this study was to investigate the clinical usefulness in detection of lymph node (LN) metastasis of thyroid cancer on real-time tissue elastography (RTE). Methods: Sixty cases were examined by RTE before surgery and those images were evaluated and classified into four patterns. Pattern 1: almost whole nodule displayed in light green. Pattern 2: light green base with blue in the periphery of the nodule. Pattern 3: blue zone base mixed with light green and red. Pattern 4: almost whole blue in the nodule. They were compared to pathological results. Results: Surgical LN dissections were performed in 78 lesions at lateral cervical areas and in 92 lesions at paratracheal areas. In 78 lateral cervical lesions, 58 (74%) lesions were detectable on B-mode and 64 (82%) lesions on RTE. In 92 paratracheal lesions, 35 (38%) lesions were detectable on B-mode and 30 (33%) lesions on RTE. Detection of LN metastasis at lateral cervical areas was improved by RTE. Conclusions: RTE demonstrated possibility of improvement in LN metastasis detection at lateral cervical areas. Though there are still some difficulties at paratracheal areas detection because of its anatomical features, RTE can provide useful information for surgical strategy.