• Ah Young Park, Jeong-Ah Kim, Eun Ju Son, and Ji Hyun Youk.
• Department of Radiology, CHA Bundang Medical Center, CHA University, Gyeonggi-do, Republic of Korea.
• Ann. Surg. Oncol. 2016 Dec 1; 23 (Suppl 5): 722-729.

BackgroundThis study aimed to investigate whether the elasticity index of shear-wave elastography (SWE) can predict cervical lymph node (LN) metastasis of papillary thyroid carcinoma (PTC).MethodsThis retrospective study included 363 patients with a surgical diagnosis of PTC who underwent preoperative SWE evaluation. The elasticity indices of PTC (E mean, E max, E min, E ratio-p, and E ratio-m) and gray-scale ultrasound (US) parameters (extrathyroidal extension, multifocality, and cervical LN metastasis) were correlated with the pathologic staging parameters. The optimal cutoff values for the elasticity indices were determined for the prediction of cervical LN metastasis, and diagnostic performance was compared between gray-scale US and the combined application of gray-scale US and SWE.ResultsThe findings showed E mean and E max to be associated with central LN metastasis (P = 0.037) and E min to be associated with lateral LN metastasis (P = 0.015). An E mean value higher than 124 kPa or an E max value higher than 138 kPa with suspicious gray-scale US findings improved the sensitivity and area under the curve (AUC) for predicting central LN metastasis (sensitivity, 45.4 and 44.6 % vs. 28 %, P < 0.001; AUC, 0.659 and 0.667 vs. 0.615, P = 0.011 and 0.019), whereas an E min value higher than 63 kPa with suspicious gray-scale US findings improved the sensitivity and AUC for predicting lateral LN metastasis (sensitivity, 95.8 vs. 75 %, P = 0.025; AUC, 0.924 vs. 0.871, P = 0.047).ConclusionThe quantitative elasticity index of PTC on preoperative SWE could be useful for predicting cervical LN metastasis.

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