Preoperative assessment of extrathyroidal extension of papillary thyroid carcinomas by ultrasound and magnetic resonance imaging: a comparative study.

Abstract

The purpose of this study was to assess and compare the diagnostic performances of preoperative ultrasonography (US) and magnetic resonance imaging (MRI) in predicting extrathyroidal extension (ETE) in patients with papillary thyroid carcinoma (PTC). This retrospective study was approved by our institutional review board. Preoperative US and MRI were performed on 225 patients who underwent surgery for PTC between May 2014 and December 2018. The US and MRI features of ETE of each case were retrospectively and independently investigated by two radiologists. The diagnostic performances of US and MRI, including their sensitivity, specificity, positive predictive values (PPV), and negative predictive values (NPV) for ETE, and their accuracy in predicting ETE were analyzed. Higher sensitivity and NPV in predicting minimal ETE were observed in US (87.5% and 76.2%, respectively) compared with MRI (71.3% and 61.7%, respectively) (p = 0.006 and p = 0.046, respectively). Meanwhile, MRI (85.4%) showed higher sensitivity than US (66.7%) in assessing extensive ETE (p = 0.005). MRI also showed significantly higher specificity and PPV than US in assessing overall ETE (p = 0.025 and p = 0.025, respectively). Preoperative US should be used as the first line in predicting minimal ETE, and MRI should be added in extensive ETE assessment. Compared with US, MRI had higher specificity and PPV in detecting the overall ETE of PTC.