Ultrasound patterns of metastases from papillary thyroid cancer in soft tissues of the neck

Abstract

Purpose of the study. To assess ultrasound features and patterns of features for metastatic papillary thyroid cancer (PTC) in soft tissues of the neck.Materials and methods. The study included 335 histologically confirmed metastases and 102 benign lymph nodes (LN). Statistical processing was carried out in the SPSS program. The reliability between the groups was assessed by criterion t with a significance level of p < 0.05. The informative value of ultrasound signs and patterns of signs, and the probability of the presence of metastasis using binary logistic regression are calculated.Results. The 14 criteria for metastasis have been studied. There are 33 signs, i.e. types of criteria. During the statistical analysis, six most informative criteria were established: calcifications, contours, shape, depth-to-width ratio in the transverse scanning plane, state (differentiation) of the cortical and cerebral layers, echostructure. To create complexes (patterns) of ultrasonic signs, a combination of these signs was used among themselves, and five patterns were established. The first pattern, including the depth-to-width ratio in the transverse scanning plane and the echo structure, has a sensitivity (Se) of 97 %, diagnostic accuracy (Ac) of 96.5 %, area under the curve (AUC) of 96 %, the probability ranges from 95 to 99 %. The Se of the second pattern, including the ratio of depth to width in the transverse scanning plane, echostructure and shape, was 97.2 %, Ac – 96.8 %, AUC – 97.3 %, probability – 95–100 %. The third pattern, including the ratio of depth to width in the transverse scanning plane, nature, shape and contours, and the fourth pattern, including the following criteria, the ratio of depth to width in the transverse scanning plane, echostructure, shape, contours and differentiation into cortical and cerebral layers, have Se 96.9 %, Ac – 97.1 %, AUC – 98.7 %, probability – 88–100 %. The fifth pattern, including the ratio of depth to width in the transverse scanning plane, echostructure, shape; contours; state (differentiation) of the cortical and cerebral layers; calcinates, has Se – 99.6 %, Ac – 99.5 %, AUC – 99.9 %, probability – 94–100 %.Conclusion. Five patterns of metastatic involvement of lymph nodes in PTC were found. The informative value of US increased from the first to the fifth pattern achieving a Se of 99.6 %, Ac of 99.5 %, AUC of 99.9 %. The probability ranged from 94 % to 100 %.