Performance of CT in the Preoperative Diagnosis of Cervical Lymph Node Metastasis in Patients with Papillary Thyroid Cancer: A Systematic Review and Meta-Analysis

Ultrasound has become widely accepted as the first imaging technique used for the assessment of cervical lymph node metastasis in patients with papillary thyroid cancer. In this systematic review and meta-analysis, we evaluate the performance of CT for the preoperative diagnosis of cervical lymph no...

Full description

Saved in:
Bibliographic Details
Published in:American journal of neuroradiology : AJNR 2017-01, Vol.38 (1), p.154-161
Main Authors: Suh, C H, Baek, J H, Choi, Y J, Lee, J H
Format: Article
Language:English
Subjects:
Adult
Cancer
Carcinoma, Papillary - pathology
Computed tomography
Correlation analysis
Correlation coefficient
Correlation coefficients
Diagnosis
Diagnostic systems
Female
Head & Neck
Humans
Lymph
Lymph nodes
Lymphatic Metastasis - diagnostic imaging
Lymphatic Metastasis - pathology
Lymphatic system
Meta-analysis
Metastases
Metastasis
Neck
Papillary thyroid cancer
Patients
Performance evaluation
Sensitivity
Sensitivity analysis
Sensitivity and Specificity
Systematic review
Thyroid
Thyroid cancer
Thyroid Cancer, Papillary
Thyroid Neoplasms - pathology
Tomography, X-Ray Computed - methods
Ultrasonic imaging
Ultrasonic testing
Ultrasound
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Ultrasound has become widely accepted as the first imaging technique used for the assessment of cervical lymph node metastasis in patients with papillary thyroid cancer. In this systematic review and meta-analysis, we evaluate the performance of CT for the preoperative diagnosis of cervical lymph node metastasis in patients with papillary thyroid cancer compared with ultrasound. Ovid-MEDLINE and EMBASE data bases were searched for studies regarding the use of CT to diagnose cervical lymph node metastasis. The diagnostic performance of CT, ultrasound, and combined CT/ultrasound was assessed by using level-by-level and patient-based analyses. We also performed meta-analyses on the basis of the central and lateral neck levels. Nine eligible studies, including a total sample size of 1691 patients, were included. CT showed a summary sensitivity of 62% (95% CI, 52%-70%) and specificity of 87% (95% CI, 80%-92%) for diagnosing cervical lymph node metastasis when using level-by-level analysis. There was a positive correlation between the sensitivity and the false-positive rate (correlation coefficient, 0.807) because of the threshold effect. The summary sensitivity of combined CT/ultrasound (69%; 95% CI, 61%-77%) was significantly higher than ultrasound (51%; 95% CI, 42%-60%), though the summary specificity did not differ. The diagnostic performances of CT and ultrasound are similar, though CT and ultrasound combined are superior to ultrasound only. CT may be used as a complementary diagnostic method in addition to ultrasound for diagnosing cervical lymph node metastasis in patients with papillary thyroid cancer.
ISSN:0195-6108
1936-959X
1936-959X
DOI:10.3174/ajnr.A4967