Dual-energy computed tomography could reliably differentiate metastatic from non-metastatic lymph nodes of less than 0.5 cm in patients with papillary thyroid carcinoma
单位：[1]Radiological Department, First Central Clinical College, Tianjin Medical University, Tianjin, China[2]Radiological Department, First TeachingHospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China[3]Radiological Department, Third Central Hospital of Tianjin, Tianjin,China[4]Department of Radiology, Tianjin First Central Hospital, School of Medicine, Nankai University, Tianjin, China[5]Radiological Department,Tianjin Hospital of ITCWM Nankai Hospital, Tianjin, China[6]Radiological Department, China-Japan Friendship Hospital, Beijing, China
Background: Dual-energy computed tomography (DECT) has been widely applied to detect lymph node (LN) and lymph node metastasis (LNM) in various cancers, including papillary thyroid carcinoma (PTC). This study aimed to quantitatively evaluate metastatic cervical lymph nodes (LNs) <0.5 cm in patients with PTC using DECT, which has not been done in previous studies. Methods: Preoperative DECT data of patients with pathologically confirmed PTC were retrospectively collected and analyzed between May 2016 and June 2018. A total of 359 LNs from 52 patients were included. Diameter, iodine concentration (IC), normalized iodine concentration (NIC), and the slope of the energy spectrum curve (lambda HU) of LNs in the arterial and the venous phases were compared between metastatic and non metastatic LNs. The optimal parameters were obtained from the receiver operating characteristic (ROC) curves. The generalized estimation equation (GEE) model was used to evaluate independent diagnostic factors for LNM. Results: A total of 139 metastatic and 220 non-metastatic LNs were analyzed. There were statistical differences of quantitative parameters between the two groups (P value 0.000-0.007). The optimal parameter for diagnosing LNM was IC in the arterial phase, and its area under the curve (AUC), sensitivity, and specificity were 0.775, 71.9%, and 73.6%, respectively. When the three parameters of diameter, IC in the arterial phase, and NIC in the venous phase were combined, the prediction efficiency was better, and the AUC was 0.819. The GEE results showed that LNs located in level VIa [odds ratio (OR) 2.030, 95% confidence interval (CI): 1.134-3.634, P=0.017], VIb (OR 2.836, 95% CI: 1.597-5.038, P=0.000), diameter (OR 2.023, 95% CI: 1.158-3.532, P=0.013), IC in the arterial phase (OR 4.444, 95% CI: 2.808-7.035, P=0.000), and IC in the venous phase (OR 5.387, 95% CI: 3.449-8.413, P=0.000) were independent risk factors for LNM in patients with PTC. Conclusions: DECT had good diagnostic performance in the differentiation of cervical metastatic LNs <0.5 cm in patients with PTC.
第一作者单位：[1]Radiological Department, First Central Clinical College, Tianjin Medical University, Tianjin, China[2]Radiological Department, First TeachingHospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
共同第一作者：
通讯作者：
通讯机构：[4]Department of Radiology, Tianjin First Central Hospital, School of Medicine, Nankai University, Tianjin, China[6]Radiological Department, China-Japan Friendship Hospital, Beijing, China[*1]24 Fukang Road, Nankai District, Department of Radiology, Tianjin First Central Hospital, School of Medicine, Nankai University, Tianjin 300192, China[*2]Yinghuayuan East Street, Chao Yang District, Beijing, China
推荐引用方式(GB/T 7714)：
Zou Ying,Zheng Meizhu,Qi Ziyu,et al.Dual-energy computed tomography could reliably differentiate metastatic from non-metastatic lymph nodes of less than 0.5 cm in patients with papillary thyroid carcinoma[J].QUANTITATIVE IMAGING in MEDICINE and SURGERY.2021,11(4):1354-+.doi:10.21037/qims-20-846.
APA：
Zou, Ying,Zheng, Meizhu,Qi, Ziyu,Guo, Yu,Ji, Xiaodong...&Xia, Shuang.(2021).Dual-energy computed tomography could reliably differentiate metastatic from non-metastatic lymph nodes of less than 0.5 cm in patients with papillary thyroid carcinoma.QUANTITATIVE IMAGING in MEDICINE and SURGERY,11,(4)
MLA：
Zou, Ying,et al."Dual-energy computed tomography could reliably differentiate metastatic from non-metastatic lymph nodes of less than 0.5 cm in patients with papillary thyroid carcinoma".QUANTITATIVE IMAGING in MEDICINE and SURGERY 11..4(2021):1354-+
