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Annals of Surgical Oncology

, Volume 22, Issue 1, pp 111–116 | Cite as

Shear Wave Elastography in Evaluation of Cervical Lymph Node Metastasis of Papillary Thyroid Carcinoma: Elasticity Index as a Prognostic Implication

  • Woo Sang Jung
  • Jeong-Ah KimEmail author
  • Eun Ju Son
  • Ji Hyun Youk
  • Cheong Soo Park
Endocrine Tumors

Abstract

Purpose

The aim of this study was to evaluate the usefulness of shear wave elastography (SWE) for predicting cervical lymph node (LN) metastasis and the prognostic implication of SWE as histopathologic factors of papillary thyroid carcinoma (PTC).

Methods

Eighty-four LNs of 66 patients with PTC underwent B-mode ultrasonography (BUS) and SWE before ultrasound-guided fine-needle aspiration biopsy or preoperative evaluation. SWE elasticity indices (EI) of mean (Emean), minimum (Emin), maximum (Emax) and the ratio of Emean in LNs and surrounding muscle (Emean−m) were measured at the stiffest portion of LNs (kPa). SWE EI were correlated with the pathologic diagnosis and the histopathologic findings, including number and size of metastatic LNs, the ratio of the number of metastatic LN/dissected LN, and the presence of extranodal extension. Diagnostic performances of SWE EI and BUS for predicting LN metastasis were assessed using receiver operating curve analysis.

Results

All SWE EI were significantly higher in metastatic LNs than in benign LNs (p < 0.005). Combined Emean [area under the curve (AUC) 0.811] or Emin (AUC 0.812) with BUS showed significantly higher AUC than BUS (0.738) for predicting metastatic LNs (p = 0.041 and 0.033, respectively). The number of positive LNs/dissected LNs and the largest LN size were significantly correlated with SWE EI (p < 0.05 and p < 0.005, respectively). Metastatic LNs with extranodal extension showed significantly higher SWE EI (p < 0.005) than those without extranodal extension.

Conclusions

Combined use of SWE and BUS was adjunctive to the diagnostic performance of BUS for the prediction of LN metastasis of PTC, and quantitative SWE could predict pathologic prognostic factors of LN metastasis of PTC.

Keywords

Papillary Thyroid Carcinoma Shear Wave Elastography Papillary Thyroid Carcinoma Patient Elasticity Index Extranodal Extension 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Conflict of interest

Woo Sang Jung, Jeong-Ah Kim, Eun Ju Son, Ji Hyun Youk, and Cheong Soo Park disclose no conflicts of interest in this study.

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Copyright information

© Society of Surgical Oncology 2014

Authors and Affiliations

  • Woo Sang Jung
    • 1
  • Jeong-Ah Kim
    • 1
    Email author
  • Eun Ju Son
    • 1
  • Ji Hyun Youk
    • 1
  • Cheong Soo Park
    • 2
  1. 1.Department of Radiology, Gangnam Severance HospitalYonsei University College of MedicineSeoulRepublic of Korea
  2. 2.Department of Surgery, Gangnam Severance HospitalYonsei University College of MedicineSeoulRepublic of Korea

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