Preoperative Lymph Node Staging by FDG PET/CT With Contrast Enhancement for Thyroid Cancer: A Multicenter Study and Comparison With Neck CT

정아리; 하정민; 한연희; 공은정; 최연정; 홍기환; 박준희; 김성훈; 박정미

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자료유형: 학술저널

저자정보: 정아리 하정민 한연희 공은정 최연정 홍기환 박준희 김성훈 박정미

저널정보: 대한이비인후과학회 Clinical and Experimental Otorhinolaryngology Clinical and Experimental Otorhinolaryngology 제10권 제1호

발행연도: 2017.1

수록면: 121 - 128 (8page)

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Objectives. The purpose of this study was to compare lymph node (LN) staging using 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) with contrast-enhancement (CE) PET/CT and contrast-enhanced neck CT (neck CT) in patients with thyroid cancer with level-by-level comparison with various factors. Methods. This was a retrospective multicenter study. A total of 85 patients were enrolled. Patients who underwent a preoperative evaluation by CE PET/CT and neck CT for thyroid cancer were enrolled. The gold standard for LN was the combination of surgical pathology and clinical follow-up. We compared CE PET/CT with neck CT using a level-by-level method. Factors, including age, sex, camera, arm position, tumor size, extra-thyroidal extension, tumor location, number of primary tumors, primary tumor maximum standardized uptake value, and the interval from scan to operation were also analyzed. Results. Overall accuracy was 81.2% for CE PET/CT and 68.2% for neck CT. CE PET/CT was more sensitive than neck CT (65.8% vs. 44.7%). Also, CE PET/CT showed higher negative predictive value (77.2% vs. 66.1%). CE PET/CT showed good agreement with the gold standard (weighted kappa [κ], 0.7) for differentiating N0, N1a, and N1b, whereas neck CT showed moderate agreement (weighted κ, 0.5). CE PET/CT showed better agreement for the number of levels involved with the gold standard (weighted κ, 0.7) than that of neck CT with the gold standard (weighted κ, 0.5). The accuracies for differentiating N0, N1a, and N1b were 81.2% for CE PET/CT and 68.2% for neck CT. Level-by-level analysis showed that CE PET/CT was more sensitive and has higher negative predictive value for detecting ipsilateral level IV and level VI LNs than neck CT. Other analyzed factors were not related to accuracies of both modalities. Conclusion. CE PET/CT was more sensitive and reliable than neck CT for preoperative LN staging in patients with thyroid cancer.

#Thyroid Neopla는 #Positron-Emission Tomography #Fluorodeoxyglucose F18 #Computed Tomography

참고문헌 (21)

참고문헌 신청

Adam MA / 2015 / Presence and number of lymph node metastases are associated with compromised survival for patients younger than age 45 years with papillary thyroid cancer /

American Joint Committee on Cancer / 2002 / AJCC cancer staging manual / Springer-Verlag

Byun BH / 2012 / Prediction of central lymph node metastasis from papillary thyroid microcarcinoma by 18F-fluorodeoxyglucose PET/CT and ultrasonography / Ann Nucl Med 26 (6)

Choi JS / 2009 / Preoperative staging of papillary thyroid carcinoma: comparison of ultrasound imaging and CT / AJR Am J Roentgenol 193 (3) : 871 ~ 878

Choi JW / 2011 / Characteristics of primary papillary thyroid carcinoma with false-negative findings on initial (18)F-FDG PET/CT / Ann Surg Oncol 18 (5) : 1306 ~ 1311

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