Using ultrasonographic features to predict patient outcomes for small papillary thyroid carcinomas: a retrospective study implementing the 2015 ATA patterns and ACR TI-RADS categories
Hee Min Park, Jihye Lee, Jin Young Kwak, Vivian Youngjean Park, Miribi Rho, Minah Lee, Jung Hyun Yoon
Department of Radiology, Severance Hospital, Research Institute of Radiological Science, Yonsei University, College of Medicine, Seoul, Korea
Corresponding Author: Jung Hyun Yoon ,Tel: 82-2-2228-7400, Fax: 82-2-2227-8337, Email:
Received: April 29, 2021;  Accepted: August 12, 2021.  Published online: August 12, 2021.
To evaluate whether risk stratification systems using US features can be associated with the outcomes of patients with small papillary thyroid carcinomas (PTCs).
This retrospective study was approved by our institutional review board. From March 2007 to February 2010, 775 patients who underwent surgery for small PTC (10-20mm in size) were included. Based on preoperative US features, PTCs were categorized according to the 2015 American Thyroid Association (2015 ATA) guideline and the American College of Radiology Thyroid Imaging Reporting and Data System (ACR-TIRADS). We evaluated the associations clinicopathological and US features had with postoperative patient outcomes.
In total, 61 patients had high-volume central lymph node metastasis (CLNM, 7.9%) and 100 patients had lateral lymph node metastasis (LLNM, 12.9%). In univariable analyses, high number of suspicious US features and higher ACR TI-RADS point totals were significantly associated with both high-volume CLNM (p=0.001, each) and LLNM (p<0.001, each). In multivariable analyses of preoperative features, higher number of suspicious US features and higher ACR TI-RADS point totals were independently associated with high-volume CLNM (OR: 1.516 and 1.201, p=0.002 and 0.001, respectively) and LLNM (OR: 1.763 and 1.293, all p<0.001). Individual US features, ATA categories, and ACR TI-RADS point totals were not significantly associated with recurrence or distant metastasis.
The number of suspicious US features and the ACR TI-RADS point total are potential risk factors of cervical LN metastasis in patients with small PTC.
Keywords: Papillary thyroid carcinoma; Ultrasonography; Lymphatic metastasis; Prognosis
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