Ultrasonography features and American college of radiology thyroid imaging reporting and data system category in the prediction of central lymph node metastasis in papillary thyroid carcinoma

The assessment of central lymph node metastasis before operation guides the surgical plan for patients with papillary thyroid carcinoma (PTC). The aim of this study was to investigate the predictive value of the ultrasonography (US) features and American College of Radiology Thyroid Imaging Reporting and Data System (ACR-TIRADS) category in central lymph node metastasis in papillary thyroid carcinoma patients.

The retrospective study of 346 papillary thyroid carcinoma patients who received diagnosis and treatment at the authors’ institution from May 2016 to December 2021 was performed. The tumors were categorized based on the US features as well as the Kwak-TIRADS or ACR-TIRADS respectively. Correlation between US features and cervical lymph node metastasis (CLNM), as well as the effects of different TI-RADS categories on the prediction of CLNM were evaluated.

A total of 164 PTC patients (47.4%) were identified with CLNM. In univariable analysis, age (P<0.001), maximum diameter (P<0.001), clinging to the capsule (P<0.001), shape (P=0.003), and ACR-TIRADS score (P<0.001) exhibited significant association with cervical lymph node metastasis in PTC patients. In multivariable analysis, age, maximum diameter, taller-than-wide shape, and clinging to the capsule were the independent factors for CLNM (P<0.05). ACR-TIRADS score was also the independent factor for CLNM (OR=1.230, 95%CI 1.016-1.488, P=0.033).

The study indicated that preoperative ultrasonography features and the ACR-TIRADS category based thereon are effective to evaluate the CLNM risk and of diagnostic value for PTC patients.