984 Comparing Modalities for the Detection of Lymph Node Metastasis in Papillary Thyroid Carcinoma: A Systematic Review and Meta-Analysis

Abstract

Abstract Aim Papillary thyroid carcinoma (PTC) is the most common cancer of the thyroid gland (Lin, 2007). Cancer cells can metastasise to the cervical lymph nodes (LNs), including the central and lateral group of LNs (Yu et al, 2020). Lymph node metastasis is an important indicator of PTC prognosis, leading to a high recurrence rate and low survival (Yu et al, 2020). Identification of LN metastasis is key for improving surgical outcomes in patients with PTC. The aim of this systematic review and meta-analysis was to compare imaging modalities for the detection of LN metastasis in PTC. Method A total of 2756 records were identified and screened following database, conference proceedings and currently registered studies search. Data from 15 case series was extracted. A random-effects meta-analysis of sensitivity and specificity of ultrasound (US), CT and MRI for the detection of LN metastasis in PTC was performed. A sub-group analysis of central and lateral LNs was also performed. Results Sensitivity for the detection of LN metastasis was the highest for MRI (69.7%, 95% CI: 45.1%-89.9%), followed by CT (63.3%, 95% CI: 44.1%-80.7%), and US (57.1%, 95% CI: 44.1%-69.7%). Specificity was highest for MRI (85.5%, 95% CI: 78.6%-91.3%), followed by US (81.2%, 95% CI: 74.7%-87.9%), and CT (80.2%, 95% CI: 67.2%-90.8%). Conclusions This meta-analysis suggests MRI should be used for the detection of LN metastasis in PTC, given it demonstrated the highest sensitivity and specificity. Accurate identification can lead to the implementation of tailored surgical and chemoradiotherapeutic treatment approaches, improving patient outcomes.