Abstract
The aim of this study was to find an accurate method for the detection of extracapsular extension (ECE) in papillary thyroid carcinoma (PTC). A total of 102 patients with 109 PTC nodules were retrospectively enrolled. Contrast-enhanced ultrasound (CEUS) characteristics were evaluated. The diagnostic efficacy of quantitative CEUS and tumor size was analyzed. The qualitative CEUS features did not differ significantly between the ECE and non-ECE groups (P > 0.05). All of the quantitative CEUS parameters with the exception of peak intensity and tumor size were found to differ significantly between the ECE and non-ECE groups (P < 0.05). Multivariate stepwise logistic regression analysis demonstrated that time from peak to one half (TPH), tumor size and wash-in slope (WIS) were the significantly different parameters between the ECE and non-ECE groups (P = 0.000, P = 0.005 and P = 0.030, respectively).The sensitivity and specificity in the diagnosis of ECE were: TPH, 75.4% (43/57) and 78.9% (41/52), respectively; WIS, 87.7% (50/57) and 42.3% (22/52), respectively; and tumor size, 71.9% (41/57) and 65.4% (34/52), respectively. Quantitative CEUS analysis and tumor size are essential for the prediction of ECE in PTC; in particular TPH has good diagnostic value in detecting ECE. Our study provides important insights into the prediction of ECE in PTC.
Highlights
The incidence of thyroid cancer has increased sharply
Detection of the presence of extracapsular extension (ECE) would be of great value in deciding the extent of surgery involving a change from lobectomy to total or near-total thyroidectomy
The accurate prediction of ECE preoperatively would be very important in avoiding unnecessary surgical resection in papillary thyroid carcinoma (PTC) patients
Summary
The incidence of thyroid cancer has increased sharply. Papillary thyroid carcinoma (PTC) is the most common pathologic type of thyroid cancer. Ultrasonography (US), multi-slice computed tomography and magnetic resonance imaging are the imaging techniques used for the detection of thyroid cancers. Doh Young Lee et al.[9] stated that the positive predictive value (PPV) of computed tomography (CT) concerning the detection of ECE in PTC patients was higher than that of US. This suggested that CT could predict ECE more accurately than US. The study of Magri F10 reported that the elastographic strain index had a high sensitivity, specificity, and negative predictive value (NPV) for identifying thyroid malignancy. Our aims were to develop a more accurate method to predict ECE preoperatively in PTC patients and to decide the extent of surgery
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