Prediction of central lymph node metastasis from papillary thyroid microcarcinoma by 18F-fluorodeoxyglucose PET/CT and ultrasonography
| Autor: | Hee-Seung Bom, Byung Hyun Byun, Ung-Gill Jeong, Jung-Joon Min, Ari Chong, Ho-Chun Song, Sun-Pyo Hong |
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| Rok vydání: | 2012 |
| Předmět: |
Adult
Male medicine.medical_specialty Multimodal Imaging Metastasis Fluorodeoxyglucose F18 medicine Carcinoma Humans Radiology Nuclear Medicine and imaging Thyroid Neoplasms Thyroid cancer Lymph node Aged Retrospective Studies Ultrasonography medicine.diagnostic_test Receiver operating characteristic business.industry Thyroid General Medicine Middle Aged medicine.disease Central lymph Carcinoma Papillary Tumor Burden medicine.anatomical_structure Positron emission tomography Thyroid Cancer Papillary Lymphatic Metastasis Positron-Emission Tomography Female Radiology business Tomography X-Ray Computed |
| Zdroj: | Annals of nuclear medicine. 26(6) |
| ISSN: | 1864-6433 |
| Popis: | The presence of central lymph node (LN) metastasis increases the risk of cervical LN recurrence or distant metastasis in patients with papillary thyroid microcarcinoma (PTMC). We investigated the value of preoperative 18F-fluoro-2-deoxy-d-glucose-positron emission tomography (FDG PET)–computerized tomography (CT) and ultrasonography (US) to predict central LN metastasis from PTMC. Two hundred patients with newly diagnosed unifocal PTMC were enrolled. Preoperative FDG PET–CT was performed, and the highest SUV (SUVmax) of focally increased uptake at thyroid was measured. Tumor size was measured using preoperative US. Uni- and multivariate analyses were performed using the presence of focally increased uptake at thyroid (FDG positivity), SUVmax, tumor size, and clinical risk factor for central LN metastasis. ROC curves for risk factors were then analyzed. These analyses were undertaken in two groups: the all patients group and the FDG-positive group. Finally, we combined risk factors associated with central LN metastasis to improve predictive accuracy. Tumor size >6 mm was associated with central LN metastasis. FDG positivity was identified in 110 patients (55.0 %) and the SUVmax ranged from 1.8 to 12.8 (median 3.0). In FDG-positive group, SUVmax >2.8 was associated with central LN metastasis. Addition of SUVmax >2.8 to size >6 mm of PTMC improved sensitivity of predicting central LN metastasis from 55.0 to 67.5 %, while specificity remained at 70.6 %. Both FDG PET–CT and US are valuable for preoperative prediction of central LN metastasis from PTMC. Combined use of SUVmax and tumor size improves sensitivity without changing specificity. |
| Databáze: | OpenAIRE |
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