title: Locally advanced thyroid cancer: can CT help in prediction of extrathyroidal invasion to adjacent structures?
abstract: OBJECTIVE
  The purpose of this study was to determine the diagnostic accuracy of CT for detecting extrathyroidal invasion of thyroid cancer to adjacent structures.
  
  
  METHODS
  Eighty-four patients (19 men, 65 women; age range, 19-84 years; mean, 54.2 +/- 15.4 years) with 86 malignant tumors of the thyroid with extracapsular extension (37 T3, 49 T4) were retrospectively enrolled in this study. Two radiologists independently evaluated the CT findings of invasion of thyroid cancer into the trachea, esophagus, common carotid artery, internal jugular vein, and recurrent laryngeal nerve. These results were compared with the surgical and histopathologic findings.
  
  
  RESULTS
  The mean sensitivity, specificity, and accuracy of CT were as follows: 59.1%, 91.4%, and 83.2% for tracheal invasion; 28.6%, 96.2%, and 90.7% for esophageal invasion; 75.0%, 99.4%, and 98.8% for invasion of the common carotid artery; 33.3%, 98.8%, and 97.1% for invasion of the internal jugular vein; and 78.2%, 89.8%, and 85.5% for invasion to the recurrent laryngeal nerve. Interobserver agreement was moderate to good in the five categories of extrathyroidal invasion with a mean kappa value of 0.65 (range, 0.49-0.77).
  
  
  CONCLUSIONS
  Although the effectiveness is limited by low sensitivity, CT may be a valuable tool for evaluation of extrathyroidal invasion of thyroid cancer to adjacent structures.
authors: Department of Radiology, Kangdong Seong-Sim Hospital, Hallym University College of Medicine, Republic of Korea.
authors: Young Lan
authors: YL
authors: Seo
authors: Dae Young
authors: DY
authors: Yoon
authors: Kyoung Ja
authors: KJ
authors: Lim
authors: Ji Hyeon
authors: JH
authors: Cha
authors: Eun Joo
authors: EJ
authors: Yun
authors: Chul Soon
authors: CS
authors: Choi
authors: Sang Hoon
authors: SH
authors: Bae
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000000981:diagnostic imaging*; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013964:Thyroid Neoplasms / Q000473:pathology*; D014057:Tomography, X-Ray Computed / Q000379:methods*