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Objective: To explore the efficacy of ultrasonic examination for diagnosing cervical lymph node metastasis in elderly patients with papillary thyroidc arcinoma(PTC), and to analyze the related ultrasonographic characteristics. Methods: A total of 232 patients ≥60 years with PTC admitted to Ruijin Hospital, Shanghai Jiao Tong University School of Medicine between January 2021 and October 2021, were included in the retrospective analysis. According to postoperative pathology, the efficacy of ultrasound in predicting cervical lymph node metastasis were calculated. Multivariate logistic regression model was used to analyze the risk factor for cervical lymph node metastasis and risk factors were used to construct multi-factor model of risk for predicting cervical lymph node metastasis. Receiver operator characteristic (ROC) curves was used to evaluate the value of the model for predicting lymph node metastasis in elderly participants with PTC. Results: Rate of cervical lymph node metastasis was 30.6% (71 cases). The sensitivity, specificity, positive predictive va-lue and negative predictive value of ultrasound for cervical lymph node metastasis were 40.8%(29/232), 93.2% (150/232), 72.5% (29/40) and 78.1% (150/192). Univariate analysrs showed that the cervical lymph node metastasis rate was higher in patients with nodule size ≥10 mm, microcalcification, abundant color Doppler flow imaging (CDFI) blood flow, or the distance between the nodule and capsule

Central lymph node (CLN) status is considered to be an important risk factor in patients with papillary thyroid carcinoma (PTC). The aim of the present study was to identify risk factors associated with CLN metastasis (CLNM) for patients with PTC based on preoperative clinical, ultrasound (US) and contrast-enhanced computed tomography (CT) characteristics, and establish a prediction model for treatment plans. A total of 786 patients with a confirmed pathological diagnosis of PTC between January 2021 to December 2022 were included in the present retrospective study, with 550 patients included in the training group and 236 patients enrolled in the validation group (ratio of 7:3). Based on the preoperative clinical, US and contrast-enhanced CT features, univariate and multivariate logistic regression analyses were used to determine the independent predictive factors of CLNM, and a personalized nomogram was constructed. Calibration curve, receiver operating characteristic (ROC) curve and decision curve analyses were used to assess discrimination, calibration and clinical application of the prediction model. As a result, 38.9% (306/786) of patients with PTC and CLNM(−) status before surgery had confirmed CLNM using postoperative pathology. In multivariate analysis, a young age (≤45 years), the male sex, no presence of Hashimoto thyroiditis, isthmic location, microcalcification, inhomogeneous enhancement and capsule invasion were independent predictors of CLNM in patients with PTC. The nomogram integrating these 7 factors exhibited strong discrimination in both the training group [Area under the curve (AUC)=0.826] and the validation group (AUC=0.818). Furthermore, the area under the ROC curve for predicting CLNM based on clinical, US and contrast-enhanced CT features was higher than that without contrast-enhanced CT features (AUC=0.818 and AUC=0.712, respectively). In addition, the calibration curve was appropriately fitted and decision curve analysis confirmed the clinical utility of the nomogram. In conclusion, the present study developed a novel nomogram for preoperative prediction of CLNM, which could provide a basis for prophylactic central lymph node dissection in patients with PTC. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the sonographic ultrasound (US) appearances of adrenal gland schwannomas.Materials and Methods: This was a retrospective analysis of 15 cases of schwannomas involving the adrenal gland. The following US features were assessed: size, border, echogenicity, homogeneity, intralesional cystic necrosis, presence of septa, intralesional calcification, posterior acoustic enhancement and blood supply.Results: Of the 15 tumors, seven (46.7%) were located on the left side, and the remaining eight (53.3%) on the right side. The most frequent US appearance of adrenal schwannoma was a single, well-defined and isoechoic mass. The internal echotexture was homogeneous in 2 cases, and heterogeneous in 13 cases, with intralesional cystic areas (n = 11), septa (n = 10) or calcifications (n = 6). Posterior acoustic enhancement was seen in 12 of the 15 cases (80%). On color Doppler US, 86.7% (13/15) of the lesions did not show any vascularity.Conclusions: Adrenal schwannomas usually present on US as well-defined isoechoic masses often with posterior acoustic enhancement, cystic necrosis with septa and poor blood supply. These appearances should suggest the diagnosis of adrenal schwannomas. Nevertheless, additional information from laboratory tests and CT or MR imaging may be required to avoid unnecessary surgery. [ABSTRACT FROM AUTHOR]

As the utilization of high-resolution imaging modalities, such as ultrasound, becomes increasingly prevalent, there has been a swift rise in the detection rates of malignant thyroid nodules (MTC). Surgery remains the cornerstone of standard treatment for these nodules. However, the advent and evolution of thermal ablation (TA) techniques, encompassing radiofrequency ablation, laser ablation, and microwave ablation, have emerged as a novel therapeutic avenue for patients with MTC, particularly for those deemed unsuitable for surgery due to high risks or for those who refuse surgery. Presently, TA has been validated as an efficacious and safe intervention for both benign thyroid nodules and a subset of MTC. An expanding body of research has been dedicated to broadening the applicability of TA, initially from recurrent thyroid cancer and lymph nodes to now encompass isolated papillary thyroid microcarcinomas (PTMC) alongside a comprehensive exploration into the expanded parameters such as size, number, and location of PTMC, and its applicability in other types of thyroid cancer. This review provides a detailed synthesis of the clinical evidence about the use of TA in the management of MTC, as endorsed by current guidelines. It further delves into the ongoing research efforts aimed at extending its indications and discusses the prospective implications and challenges of integrating TA into the clinical management paradigms for MTC.