Preoperative hydrodissection for predicting extrathyroidal extension in thyroid tumors

Area of Science:

• Radiology
• Oncology
• Endocrinology

Background:

• Evaluating diagnostic performance of preoperative hydrodissection and grey-scale ultrasound (US) for predicting extra-thyroidal extension (ETE) in subcapsular thyroid lesions.
• Retrospective study analyzing hydrodissection for subcapsular thyroid nodules between September 2023 and March 2025.

Purpose of the Study:

• To compare the diagnostic performance of hydrodissection versus conventional ultrasound (US) in predicting extra-thyroidal extension (ETE) of subcapsular thyroid nodules.
• To assess the efficacy of hydrodissection in identifying ETE in K-TIRADS 5 nodules and thyroid tumors.

Main Methods:

• Included 40 nodules from 33 patients; 18 nodules were tumors, with 15 malignant.
• ETE determination for US based on capsule disruption, bulging contour, and perithyroidal infiltrations.
• ETE determination for hydrodissection based on encountered resistance during the procedure.

Main Results:

• Hydrodissection showed significantly better specificity (0.96 vs. 0.63), accuracy (0.93 vs. 0.61), and AUC (0.854 vs. 0.563) for K-TIRADS 5 nodules.
• For thyroid tumors, hydrodissection demonstrated higher accuracy (0.89 vs. 0.56) and AUC (0.839 vs. 0.536) compared to US.
• Four malignant nodules demonstrated ETE.

Conclusions:

• Hydrodissection exhibits superior diagnostic performance in predicting ETE compared to conventional ultrasound.
• The findings suggest hydrodissection is a more accurate method for assessing ETE in subcapsular thyroid nodules.
• This technique enhances the preoperative evaluation of thyroid lesions, aiding in surgical planning.