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Accuracy of MRI for the diagnosis of metastatic cervical lymphadenopathy in patients with thyroid cancer

Chen, Qinghua ; Raghavan, Prashant ; Mukherjee, Sugoto ; Jameson, Mark ; Patrie, James ; Xin, Wenjun ; Xian, Junfang ; Wang, Zhenchang ; Levine, Paul ; Wintermark, Max

In: La radiologia medica, 2015, vol. 120, no. 10, p. 959-966

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    Titre
    • Accuracy of MRI for the diagnosis of metastatic cervical lymphadenopathy in patients with thyroid cancer
    Auteur
    • Chen, Qinghua. UVA Department of Radiology, Neuroradiology Division, University of Virginia, Box 800170, 22908, Charlottesville, VA, USA
    • Raghavan, Prashant. UVA Department of Radiology, Neuroradiology Division, University of Virginia, Box 800170, 22908, Charlottesville, VA, USA
    • Mukherjee, Sugoto. UVA Department of Radiology, Neuroradiology Division, University of Virginia, Box 800170, 22908, Charlottesville, VA, USA
    • Jameson, Mark. Department of Otolaryngology - Head and Neck Surgery, University of Virginia, Charlottesville, VA, USA
    • Patrie, James. Department of Public Health Sciences, University of Virginia, Charlottesville, VA, USA
    • Xin, Wenjun. Department of Public Health Sciences, University of Virginia, Charlottesville, VA, USA
    • Xian, Junfang. Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
    • Wang, Zhenchang. Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
    • Levine, Paul. Department of Otolaryngology - Head and Neck Surgery, University of Virginia, Charlottesville, VA, USA
    • Wintermark, Max. UVA Department of Radiology, Neuroradiology Division, University of Virginia, Box 800170, 22908, Charlottesville, VA, USA
    Type de document
    • Postprint
    Identifiant OAI-PMH
    • oai:doc.rero.ch:332824
    Summary
    Purpose: The aim of this study was to systematically compare a comprehensive array of magnetic resonance (MR) imaging features in terms of their sensitivity and specificity to diagnose cervical lymph node metastases in patients with thyroid cancer. Materials and methods: The study included 41 patients with thyroid malignancy who underwent surgical excision of cervical lymph nodes and had preoperative MR imaging ≤4weeks prior to surgery. Three head and neck neuroradiologists independently evaluated all the MR images. Using the pathology results as reference, the sensitivity, specificity and interobserver agreement of each MR imaging characteristic were calculated. Results: On multivariate analysis, no single imaging feature was significantly correlated with metastasis. In general, imaging features demonstrated high specificity, but poor sensitivity and moderate interobserver agreement at best. Conclusions: Commonly used MR imaging features have limited sensitivity at correctly identifying cervical lymph node metastases in patients with thyroid cancer. A negative neck MR scan should not dissuade a surgeon from performing a neck dissection in patients with thyroid carcinomas.