Is ultrasonographic evaluation sensitive enough to detect multicentric papillary thyroid carcinoma?

Area of Science:

• Radiology
• Oncology
• Pathology

Background:

• Multicentric papillary thyroid carcinoma (PTC) presents diagnostic challenges.
• Preoperative ultrasonography (US) is crucial for evaluating PTC.
• Understanding US findings in relation to tumor characteristics is essential.

Purpose of the Study:

• To investigate the preoperative US evaluation of multicentric PTC.
• To assess the association of US findings with lymph node metastasis and extracapsular extension in PTC.

Main Methods:

• Retrospective analysis of preoperative US in 89 PTC patients undergoing total thyroidectomy.
• Evaluation of US features and pathological correlation.
• Assessment of US sensitivity for multicentric PTC, lymph node metastasis, and extracapsular extension.

Main Results:

• 37.08% of PTC cases were multicentric; only 23 patients were suspected preoperatively via US.
• US missed malignant nodules in 51.51% of multicentric PTC cases, particularly micronodules (1-4 mm).
• US demonstrated high sensitivity (>80%) for extracapsular extension but low sensitivity for lymph node metastasis.

Conclusions:

• Preoperative US is not sufficiently sensitive for detecting multicentric PTC, especially small nodules.
• US is a valuable tool for assessing extracapsular extension in PTC.
• Ultrasonography has limited accuracy in diagnosing lymph node metastasis in PTC.