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Ultrasonographic Features of Medullary Thyroid Carcinoma: Do they Correlate with Pre- and Post-Operative Calcitonin Levels?

  • Cho, Kyung Eun (Department of Radiology and Research Institute of Radiological Science Yonsei University, College of Medicine) ;
  • Gweon, Hye Mi (Department of Radiology and Research Institute of Radiological Science Yonsei University, College of Medicine) ;
  • Park, Ah Young (Department of Radiology and Research Institute of Radiological Science Yonsei University, College of Medicine) ;
  • Yoo, Mi Ri (Department of Radiology and Research Institute of Radiological Science Yonsei University, College of Medicine) ;
  • Kim, Jeong-Ah (Department of Radiology and Research Institute of Radiological Science Yonsei University, College of Medicine) ;
  • Youk, Ji Hyun (Department of Radiology and Research Institute of Radiological Science Yonsei University, College of Medicine) ;
  • Park, Young Mi (Department of Radiology, Korea university ansan hospital) ;
  • Son, Eun Ju (Department of Radiology and Research Institute of Radiological Science Yonsei University, College of Medicine)
  • Published : 2016.07.01

Abstract

Purpose: To correlate ultrasonographic (US) features of medullary thyroid carcinoma (MTC) with preoperative and post-operative calcitonin levels. Materials and Methods: A total of 130 thyroid nodules diagnosed as MTC were evaluated. Two radiologists retrospectively evaluated preoperative US features according to size, shape, margin, echogenicity, type of calcification, and lymph node status. Postoperative clinical and imaging follow-up (mean duration $31.9 {\pm} 22.5$ months) was performed for detection of tumor recurrence. US features, presence of LN metastasis, and tumor recurrence were compared between MTC nodules with and without elevated preoperative calcitonin (>100 pg/mL). Those with normalized and non-normalized postoperative calcitonin levels groups were also compared. Results: Common US features of MTCs were solid internal content (90.8%), irregular shape (44.6%), circumscribed margin (46.2%), and hypoechogenicity (56.2%). Comparing MTC nodules with and without elevated preoperative calcitonin levels, the size and shape of MTC nodule and lymph node metastasis showed statistical significance (p<0.05). Postoperative calcitonin normalization correlated with US features of tumor size (p=0.002), margin (p=0.034), shape ($p{\leq}0.001$), and presence of calcification (p=0.046). Tumor recurrence and LN metastasis were more prevalent in patients without normalization of postoperative calcitonin than in those with normalization (p=0.001). Conclusions: Serum calcitonin measurement is helpful for early diagnosis and predicting prognosis. Postoperative calcitonin measurement is also important for postoperative US follow up, especially in cases with larger nodule size, presence of calcification, irregular shape, and irregular margin.

Keywords

Medullary thyroid cancer;ultrasonographic features;preoperative calcitonin;postoperative calcitonin

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