Diagnostic Potential of Ultrasonography and Computed Tomography in Differentiating Cervical Lymph Node Metastasis of Thyroid Cancer: a Systematic Review and Meta-analysis

Overview

Journal Arch Med Sci

Specialty General Medicine

Date 2023 Aug 10

PMID 37560722

Authors

Yong-Hui Chen

Ying-Qiang Zhang

Affiliations

Soon will be listed here.

Abstract

Introduction: Ultrasonography (US) and computed tomography (CT) are the most common diagnostic modalities of cervical lymph node metastasis of thyroid cancer, but few studies have been conducted to compare their diagnostic accuracy, with inconclusive results.

Material And Methods: Multiple databases including PubMed, Springer, EMBASE, Ovid, and the Cochrane Library were searched with the keywords "thyroid cancer OR thyroid carcinomas", "cervical lymph nodes", "metastatic OR metastasis", and "ultrasonography OR ultrasound OR CT OR computed tomography" in June 2018. Full-text articles comparing diagnostic accuracy of US and CT were reviewed. Meta-analyses were conducted to estimate sensitivity and specificity. The forest plots of sensitivity and specificity and summary receiver operating characteristic curves (SROC) are also presented in this article.

Results: Finally, 8 of 1785 studies which eventually met the inclusion criteria were selected in this study. The mean sensitivities and specificities of CT in whole and central cervical areas were 0.65, 0.56 and 0.89, 0.83, respectively, while for US, the sensitivities and specificities were 0.58, 0.39 and 0.89, 0.91, respectively. The area under the curve (AUCs) observed of CT and US in whole, central and lateral cervical areas were 0.79 vs. 0.79, and 0.76 vs. 0.67. Because only a few articles were included in this study, publication bias was not assessed.

Conclusions: The diagnostic accuracy of US and CT was comparable. The specificity of these two methods was much higher than the sensitivity.

References

Yoon D, Hwang H, Chang S, Rho Y, Ahn H, Kim J . CT, MR, US,18F-FDG PET/CT, and their combined use for the assessment of cervical lymph node metastases in squamous cell carcinoma of the head and neck. Eur Radiol. 2008; 19(3):634-42. DOI: 10.1007/s00330-008-1192-6. View

King A, Tse G, Ahuja A, Yuen E, Vlantis A, To E . Necrosis in metastatic neck nodes: diagnostic accuracy of CT, MR imaging, and US. Radiology. 2004; 230(3):720-6. DOI: 10.1148/radiol.2303030157. View

Kupferman M, Patterson M, Mandel S, LiVolsi V, Weber R . Patterns of lateral neck metastasis in papillary thyroid carcinoma. Arch Otolaryngol Head Neck Surg. 2004; 130(7):857-60. DOI: 10.1001/archotol.130.7.857. View

McHenry C, Rosen I, Walfish P . Prospective management of nodal metastases in differentiated thyroid cancer. Am J Surg. 1991; 162(4):353-6. DOI: 10.1016/0002-9610(91)90147-6. View

Kusacic Kuna S, Bracic I, Tesic V, Kuna K, Herceg G, Dodig D . Ultrasonographic differentiation of benign from malignant neck lymphadenopathy in thyroid cancer. J Ultrasound Med. 2006; 25(12):1531-7. DOI: 10.7863/jum.2006.25.12.1531. View

Ito Y, Tomoda C, Uruno T, Takamura Y, Miya A, Kobayashi K . Preoperative ultrasonographic examination for lymph node metastasis: usefulness when designing lymph node dissection for papillary microcarcinoma of the thyroid. World J Surg. 2004; 28(5):498-501. DOI: 10.1007/s00268-004-7192-z. View

Sarvanan K, Bapuraj J, Sharma S, Radotra B, Khandelwal N, Suri S . Computed tomography and ultrasonographic evaluation of metastatic cervical lymph nodes with surgicoclinicopathologic correlation. J Laryngol Otol. 2002; 116(3):194-9. DOI: 10.1258/0022215021910519. View

Jeong H, Baek C, Son Y, Choi J, Kim H, Ko Y . Integrated 18F-FDG PET/CT for the initial evaluation of cervical node level of patients with papillary thyroid carcinoma: comparison with ultrasound and contrast-enhanced CT. Clin Endocrinol (Oxf). 2006; 65(3):402-7. DOI: 10.1111/j.1365-2265.2006.02612.x. View

Caron N, Tan Y, Ogilvie J, Triponez F, Reiff E, Kebebew E . Selective modified radical neck dissection for papillary thyroid cancer-is level I, II and V dissection always necessary?. World J Surg. 2006; 30(5):833-40. DOI: 10.1007/s00268-005-0358-5. View

10.

Cobin R, Gharib H, Bergman D, Clark O, Cooper D, Daniels G . AACE/AAES medical/surgical guidelines for clinical practice: management of thyroid carcinoma. American Association of Clinical Endocrinologists. American College of Endocrinology. Endocr Pract. 2001; 7(3):202-20. View

11.

Short S, Kaplan J, Laramore G, Cummings C . Shoulder pain and function after neck dissection with or without preservation of the spinal accessory nerve. Am J Surg. 1984; 148(4):478-82. DOI: 10.1016/0002-9610(84)90373-8. View

12.

Esnaola N, Cantor S, Sherman S, Lee J, Evans D . Optimal treatment strategy in patients with papillary thyroid cancer: a decision analysis. Surgery. 2001; 130(6):921-30. DOI: 10.1067/msy.2001.118370. View

13.

Kim E, Park J, Son K, Kim J, Jeon S, Na D . Preoperative diagnosis of cervical metastatic lymph nodes in papillary thyroid carcinoma: comparison of ultrasound, computed tomography, and combined ultrasound with computed tomography. Thyroid. 2008; 18(4):411-8. DOI: 10.1089/thy.2007.0269. View

14.

Caron N, Clark O . Papillary thyroid cancer: surgical management of lymph node metastases. Curr Treat Options Oncol. 2005; 6(4):311-22. DOI: 10.1007/s11864-005-0035-9. View

15.

Antonelli A, Miccoli P, Ferdeghini M, Di Coscio G, Alberti B, Iacconi P . Role of neck ultrasonography in the follow-up of patients operated on for thyroid cancer. Thyroid. 1995; 5(1):25-8. DOI: 10.1089/thy.1995.5.25. View

16.

Stulak J, Grant C, Farley D, Thompson G, van Heerden J, Hay I . Value of preoperative ultrasonography in the surgical management of initial and reoperative papillary thyroid cancer. Arch Surg. 2006; 141(5):489-94. DOI: 10.1001/archsurg.141.5.489. View

17.

Kouvaraki M, Shapiro S, Fornage B, Edeiken-Monro B, Sherman S, Vassilopoulou-Sellin R . Role of preoperative ultrasonography in the surgical management of patients with thyroid cancer. Surgery. 2003; 134(6):946-54. DOI: 10.1016/s0039-6060(03)00424-0. View

18.

Shah J, Loree T, Dharker D, Strong E, Begg C, Vlamis V . Prognostic factors in differentiated carcinoma of the thyroid gland. Am J Surg. 1992; 164(6):658-61. DOI: 10.1016/s0002-9610(05)80729-9. View

19.

Lee D, Ji Y, Sung E, Park J, Lee Y, Park D . Roles of ultrasonography and computed tomography in the surgical management of cervical lymph node metastases in papillary thyroid carcinoma. Eur J Surg Oncol. 2012; 39(2):191-6. DOI: 10.1016/j.ejso.2012.07.119. View

20.

Mazzaferri E, Jhiang S . Long-term impact of initial surgical and medical therapy on papillary and follicular thyroid cancer. Am J Med. 1994; 97(5):418-28. DOI: 10.1016/0002-9343(94)90321-2. View