B-Flow Twinkling Sign in Preoperative Evaluation of Cervical Lymph Nodes in Patients with Papillary Thyroid Carcinoma

Papillary thyroid cancer (PTC) is the most common histologic type of differentiated thyroid cancer. The first site of metastasis is the cervical lymph nodes (LNs). The ultrasonography (US) is the best diagnostic method for the detection of cervical metastatic LNs. We use a new technique, B-flow imag...

Full description

Saved in:
Bibliographic Details
Main Authors: Giuseppina Napolitano, Antonio Romeo, Andrea Bianco, Maurizio Gasperi, Pio Zeppa, Luca Brunese
Format: Article
Language:English
Published: Wiley 2013-01-01
Series:International Journal of Endocrinology
Online Access:http://dx.doi.org/10.1155/2013/203610
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1832545554063687680
author Giuseppina Napolitano
Antonio Romeo
Andrea Bianco
Maurizio Gasperi
Pio Zeppa
Luca Brunese
author_facet Giuseppina Napolitano
Antonio Romeo
Andrea Bianco
Maurizio Gasperi
Pio Zeppa
Luca Brunese
author_sort Giuseppina Napolitano
collection DOAJ
description Papillary thyroid cancer (PTC) is the most common histologic type of differentiated thyroid cancer. The first site of metastasis is the cervical lymph nodes (LNs). The ultrasonography (US) is the best diagnostic method for the detection of cervical metastatic LNs. We use a new technique, B-flow imaging (BFI), recently used for evaluation of thyroid nodules, to estimate the presence of BFI twinkling signs (BFI-TS), within metastatic LNs in patients with PTC. Two hundred and fifty-two patients with known PTC were examined for preoperative evaluation with conventional US and BFI. Only 83 with at least one metastatic LN were included. All patients included underwent surgery; the final diagnosis was based on the results of histology. The following LN characteristics were evaluated: shape, abnormal echogenicity, absent hilum, calcifications, cystic appearance, peripheral vascularization, and BFI-TS. A total of 604 LNs were analyzed. Of these, 298 were metastatic, according to histopathology. The BFI-TS showed high values ​​of specificity (99.7%) and sensitivity (80.9%). The combination of each conventional US sign with the BF-TS increases the specificity. Our findings suggest that BFI can be helpful in the selection of suspicious neck LNs that should be examined at cytologic examination for accurate preoperative staging and individual therapy selection.
format Article
id doaj-art-0c119af2a1ea43f39e74c5b4d9945c10
institution Kabale University
issn 1687-8337
1687-8345
language English
publishDate 2013-01-01
publisher Wiley
record_format Article
series International Journal of Endocrinology
spelling doaj-art-0c119af2a1ea43f39e74c5b4d9945c102025-02-03T07:25:20ZengWileyInternational Journal of Endocrinology1687-83371687-83452013-01-01201310.1155/2013/203610203610B-Flow Twinkling Sign in Preoperative Evaluation of Cervical Lymph Nodes in Patients with Papillary Thyroid CarcinomaGiuseppina Napolitano0Antonio Romeo1Andrea Bianco2Maurizio Gasperi3Pio Zeppa4Luca Brunese5Department of Health Science, Chair of Radiology, University of Molise, Contrada Tappino, 86100 Campobasso, ItalyDepartment of Health Science, Chair of Radiology, University of Molise, Contrada Tappino, 86100 Campobasso, ItalyDepartment of Health Science, Chair of Radiology, University of Molise, Contrada Tappino, 86100 Campobasso, ItalyDepartment of Health Science, Chair of Radiology, University of Molise, Contrada Tappino, 86100 Campobasso, ItalyDepartment of Medicine and Surgery, the University of Salerno (IT), ItalyDepartment of Health Science, Chair of Radiology, University of Molise, Contrada Tappino, 86100 Campobasso, ItalyPapillary thyroid cancer (PTC) is the most common histologic type of differentiated thyroid cancer. The first site of metastasis is the cervical lymph nodes (LNs). The ultrasonography (US) is the best diagnostic method for the detection of cervical metastatic LNs. We use a new technique, B-flow imaging (BFI), recently used for evaluation of thyroid nodules, to estimate the presence of BFI twinkling signs (BFI-TS), within metastatic LNs in patients with PTC. Two hundred and fifty-two patients with known PTC were examined for preoperative evaluation with conventional US and BFI. Only 83 with at least one metastatic LN were included. All patients included underwent surgery; the final diagnosis was based on the results of histology. The following LN characteristics were evaluated: shape, abnormal echogenicity, absent hilum, calcifications, cystic appearance, peripheral vascularization, and BFI-TS. A total of 604 LNs were analyzed. Of these, 298 were metastatic, according to histopathology. The BFI-TS showed high values ​​of specificity (99.7%) and sensitivity (80.9%). The combination of each conventional US sign with the BF-TS increases the specificity. Our findings suggest that BFI can be helpful in the selection of suspicious neck LNs that should be examined at cytologic examination for accurate preoperative staging and individual therapy selection.http://dx.doi.org/10.1155/2013/203610
spellingShingle Giuseppina Napolitano
Antonio Romeo
Andrea Bianco
Maurizio Gasperi
Pio Zeppa
Luca Brunese
B-Flow Twinkling Sign in Preoperative Evaluation of Cervical Lymph Nodes in Patients with Papillary Thyroid Carcinoma
International Journal of Endocrinology
title B-Flow Twinkling Sign in Preoperative Evaluation of Cervical Lymph Nodes in Patients with Papillary Thyroid Carcinoma
title_full B-Flow Twinkling Sign in Preoperative Evaluation of Cervical Lymph Nodes in Patients with Papillary Thyroid Carcinoma
title_fullStr B-Flow Twinkling Sign in Preoperative Evaluation of Cervical Lymph Nodes in Patients with Papillary Thyroid Carcinoma
title_full_unstemmed B-Flow Twinkling Sign in Preoperative Evaluation of Cervical Lymph Nodes in Patients with Papillary Thyroid Carcinoma
title_short B-Flow Twinkling Sign in Preoperative Evaluation of Cervical Lymph Nodes in Patients with Papillary Thyroid Carcinoma
title_sort b flow twinkling sign in preoperative evaluation of cervical lymph nodes in patients with papillary thyroid carcinoma
url http://dx.doi.org/10.1155/2013/203610
work_keys_str_mv AT giuseppinanapolitano bflowtwinklingsigninpreoperativeevaluationofcervicallymphnodesinpatientswithpapillarythyroidcarcinoma
AT antonioromeo bflowtwinklingsigninpreoperativeevaluationofcervicallymphnodesinpatientswithpapillarythyroidcarcinoma
AT andreabianco bflowtwinklingsigninpreoperativeevaluationofcervicallymphnodesinpatientswithpapillarythyroidcarcinoma
AT mauriziogasperi bflowtwinklingsigninpreoperativeevaluationofcervicallymphnodesinpatientswithpapillarythyroidcarcinoma
AT piozeppa bflowtwinklingsigninpreoperativeevaluationofcervicallymphnodesinpatientswithpapillarythyroidcarcinoma
AT lucabrunese bflowtwinklingsigninpreoperativeevaluationofcervicallymphnodesinpatientswithpapillarythyroidcarcinoma