Department of Radiology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea.
Department of Radiology, New Korea Hospital/Human Medical Imaging and Intervention Center, Gimpo, Korea.
Cancer Res Treat. 2018 Jan;50(1):11-18. doi: 10.4143/crt.2016.600. Epub 2017 Feb 24.
The purpose of this study was to evaluate the diagnostic performance and cost of screening thyroid ultrasonography (US) in an asymptomatic population and determine the US features of screening-detected thyroid cancer.
This study included 1,845 asymptomatic participants who underwent screening thyroid US between March and August 2012 at the screening center in our hospital. We evaluated the diagnostic performance of screening thyroid US for thyroid cancer and the average cost of diagnosis for each patient. We also determined the characteristic US features of screening-detected thyroid cancer.
Of the 1,845 subjects, 661 showed no abnormalities, 1,155 exhibited benign thyroid nodules, and 29 exhibited thyroid cancer. Imaging features such as solid composition, hypoechogenicity, taller-than-wide axis, and ill-defined or spiculated margins of nodules were suggestive of malignancy. The rate of detection of cancer was 1.6% (29/1,845), and the sensitivity, specificity, and positive and negative predictive values were 100% (18/18), 98.7% (1,051/1,065), 56.3% (18/32), and 100% (1,051/1,051), respectively. Of 18 patients who underwent thyroidectomy, three (16.7%) had a pathological tumor staging of T3, and four (22.2%) had a pathological nodal staging of N1a. The average cost of diagnosis for each patient with cancer was $7,319.
Screening thyroid US exhibited a good diagnostic performance, with a feasible social cost of use. This modality demonstrated significant differences in sonographic features between screening-detected cancer and benign nodules.
本研究旨在评估无症状人群中甲状腺超声（US）筛查的诊断性能和成本，并确定筛查发现的甲状腺癌的 US 特征。
本研究纳入了 2012 年 3 月至 8 月期间在我院筛查中心接受筛查性甲状腺 US 的 1845 名无症状参与者。我们评估了筛查性甲状腺 US 对甲状腺癌的诊断性能以及每位患者的平均诊断费用。我们还确定了筛查发现的甲状腺癌的特征性 US 特征。
在 1845 名受试者中，661 名无异常，1155 名表现为良性甲状腺结节，29 名表现为甲状腺癌。影像学特征如实性成分、低回声、高宽比、边界不清或锯齿状提示恶性。癌症的检出率为 1.6%（29/1845），敏感性、特异性、阳性预测值和阴性预测值分别为 100%（18/18）、98.7%（1051/1065）、56.3%（18/32）和 100%（1051/1051）。在 18 例接受甲状腺切除术的患者中，有 3 例（16.7%）存在 T3 病理肿瘤分期，4 例（22.2%）存在 N1a 病理淋巴结分期。每位癌症患者的平均诊断费用为 7319 美元。
筛查性甲状腺 US 具有良好的诊断性能，且具有可行的社会使用成本。该方法在筛查发现的癌症与良性结节之间的超声特征方面表现出显著差异。
