CT成像在解决差异化甲状腺癌切除性问题的作用:基于图像的TI和ETE的Mahajan分级系统
Abhishek Mahajan1,2,3, Shivam Rastogi3, Shreya Shukla3,4
1Imaging Department, The Clatterbridge Cancer Centre NHS Foundation Trust, Liverpool, United Kingdom.
Frontiers in oncology
|September 30, 2024
概括
计算机断层扫描 (CT) 和超声波 (US) 有效地评估皮质甲状腺癌 (PTC) 的甲状腺外延伸 (ETE) 和气管入侵 (TI). CT为ETE和TI提供了更高的特异性,而US在检测最小ETE方面表现出色,有助于术前规划.
科学领域:
- 放射学 放射学是一门学科.
- 在瘤学瘤学.
- 医疗成像医学成像
背景情况:
- 甲状腺外延伸 (ETE) 表示甲状腺瘤生长超出甲状腺囊,是关键的预后指标.
- 对ETE和气管侵入 (TI) 的准确手术前评估对于差异化乳头甲状腺癌 (PTC) 管理至关重要.
- 目前的成像方法需要评估以获得最佳的手术前预测ETE和TI.
研究的目的:
- 评估基于计算机断层扫描 (CT) 的ETE和TI等级在PTC中的诊断性能.
- 为了比较CT与超声波 (US) 的诊断准确度,用于术前预测ETE和TI.
- 评估基于美国和CT的分级系统在优化外科手术规划方面的实用性.
主要方法:
- 从经过手术的83名PTC患者手术前US和CT扫描的回顾性分析.
- 两个放射科医生对ETE和TI的US和CT特征进行了独立审查.
- 在US/CT上应用ETE三级系统,在CT上应用四级Mahajan分级系统,用于TI预测.
主要成果:
- CT显示高精度 (8287%) 和特异性 (9598%) 识别瘤透到相邻结构,但较低的灵敏度与美国相比.
- 在检测TI时,CT显示了提高的灵敏度 (78%) 和特异性 (75%).
- 对于TI预测,CT Mahajan分级实现了91.5% (p < 0.005) 的诊断准确度.
结论:
- 推US作为最小ETE检测的第一线模式,CT对最大ETE评估有价值.
- 与美国相比,CT在PTC中对ETE和TI的总体检测具有更高的特异性和正预测值 (PPV).
- 基于美国和CT的分级系统都显示出增强PTC患者手术前外科计划的潜力.
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